Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.92 / $90.72 / $108.00	Facility		$79.92	$90.72	$108.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $143.27 / $143.27 / $179.00	Facility		$143.27	$143.27	$179.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.25 / $25.00 / $25.00	Facility		$21.25	$25.00	$25.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Facility		$25.00	$25.00	$25.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $40.47 / $40.47	Professional		$40.47	$40.47	$40.47