Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $77.62 / $204.17	Facility		$28.84	$77.62	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.84 / $42.66	Professional		$22.91	$28.84	$42.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $389.05 / $741.31	Facility		$131.83	$389.05	$741.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $9.55 / $9.55	Professional		$9.55	$9.55	$9.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $67.61 / $169.82	Facility		$19.05	$67.61	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $21.38 / $46.77	Professional		$12.30	$21.38	$46.77
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $33.11 / $63.10	Facility		$17.78	$33.11	$63.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.84 / $43.65	Professional		$22.91	$28.84	$43.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $33.11 / $66.07	Facility		$16.22	$33.11	$66.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $21.38 / $51.29	Professional		$12.30	$21.38	$51.29
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 $10.96 / $17.78 / $25.70	Professional		$10.96	$17.78	$25.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $17.38 / $21.38	Professional		$5.50	$17.38	$21.38