Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.98 / $361.91 / $1,909.22	Facility		$63.98	$361.91	$1,909.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.32 / $195.19 / $234.98	Professional		$134.32	$195.19	$234.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,801.27 / $3,782.67 / $8,267.83	Facility		$1,801.27	$3,782.67	$8,267.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,801.27 / $1,801.27 / $1,801.27	Professional		$1,801.27	$1,801.27	$1,801.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.26 / $143.26 / $143.26	Facility		$143.26	$143.26	$143.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.26 / $143.26 / $143.26	Professional		$143.26	$143.26	$143.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,844.67 / $2,170.19 / $2,170.19	Facility		$1,844.67	$2,170.19	$2,170.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,742.91 / $3,742.91 / $3,742.91	Professional		$3,742.91	$3,742.91	$3,742.91
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $199.09 / $2,170.19 / $2,170.19	Facility		$199.09	$2,170.19	$2,170.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $159.26 / $159.26 / $159.26	Professional		$159.26	$159.26	$159.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $186.45 / $278.72 / $292.66	Professional		$186.45	$278.72	$292.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $143.26 / $276.20 / $2,170.19	Facility		$143.26	$276.20	$2,170.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.26 / $143.26 / $143.26	Professional		$143.26	$143.26	$143.26
United Facility/Professional Professional Modifier Low / Median / High Price $2,170.19 / $2,170.19 / $2,198.41	Professional		$2,170.19	$2,170.19	$2,198.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $792.50 / $792.50 / $1,069.88	Professional		$792.50	$792.50	$1,069.88