Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $38.90	Professional		$30.20	$38.90	$38.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $39.81	Facility		$19.95	$19.95	$39.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
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 $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $39.81	Facility		$19.95	$19.95	$39.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $79.43	Professional		$60.26	$60.26	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $14.13	Professional		$14.13	$14.13	$14.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $10.96 / $13.49	Professional		$10.96	$10.96	$13.49