Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $25.12 / $28.18	Facility		$20.89	$25.12	$28.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.18 / $51.29	Professional		$22.91	$28.18	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $45.71 / $45.71	Facility		$45.71	$45.71	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $34.67 / $58.88	Professional		$26.92	$34.67	$58.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $245.47	Professional		$173.78	$245.47	$245.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $32.36 / $83.18	Facility		$25.70	$32.36	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $28.18 / $151.36	Professional		$25.12	$28.18	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.30 / $30.20	Professional		$21.38	$26.30	$30.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $165.96 / $199.53	Professional		$30.20	$165.96	$199.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $34.67 / $79.43	Facility		$25.70	$34.67	$79.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.88 / $53.70	Professional		$25.70	$33.88	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $31.62 / $48.98	Professional		$23.99	$31.62	$48.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $43.65	Professional		$30.20	$34.67	$43.65