Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $144.54 / $407.38	Facility		$52.48	$144.54	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $81.28	Professional		$41.69	$54.95	$81.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $398.11 / $758.58	Facility		$158.49	$398.11	$758.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Professional		$42.66	$42.66	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $125.89 / $316.23	Facility		$37.15	$125.89	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $40.74 / $89.13	Professional		$23.44	$40.74	$89.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $64.57 / $120.23	Facility		$45.71	$64.57	$120.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $81.28	Professional		$41.69	$54.95	$81.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $53.70	Professional		$30.20	$42.66	$53.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $64.57 / $128.82	Facility		$44.67	$64.57	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $40.74 / $95.50	Professional		$23.44	$40.74	$95.50
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $269.15 / $354.81	Facility		$138.04	$269.15	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $33.11 / $47.86	Professional		$21.38	$33.11	$47.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $16.60 / $52.48	Professional		$14.79	$16.60	$52.48