Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.00 / $126.08 / $126.08	Facility		$123.00	$126.08	$126.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $126.08 / $130.69	Professional		$123.00	$126.08	$130.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Facility		$130.69	$130.69	$130.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Professional		$130.69	$130.69	$130.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $153.75 / $267.19	Facility		$75.00	$153.75	$267.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $270.75 / $461.25 / $607.30	Professional		$270.75	$461.25	$607.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $119.26 / $153.75 / $267.29	Facility		$119.26	$153.75	$267.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.63 / $55.63 / $137.61	Professional		$55.63	$55.63	$137.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $99.97 / $119.39	Professional		$99.97	$99.97	$119.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $119.26 / $153.75 / $266.77	Facility		$119.26	$153.75	$266.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Professional		$130.69	$130.69	$130.69
United Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $128.13 / $130.82	Professional		$128.13	$128.13	$130.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $61.16 / $82.57	Professional		$57.00	$61.16	$82.57