Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $6,165.95 / $6,165.95	Facility		$1,659.59	$6,165.95	$6,165.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,698.24 / $1,905.46	Professional		$1,659.59	$1,698.24	$1,905.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $3,630.78 / $6,918.31	Facility		$1,445.44	$3,630.78	$6,918.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Facility		$6,165.95	$6,165.95	$6,165.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Professional		$9,332.54	$9,332.54	$9,332.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,041.74 / $6,165.95	Facility		$1,659.59	$2,041.74	$6,165.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,698.24 / $1,737.80	Professional		$1,548.82	$1,698.24	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,659.59 / $2,041.74 / $5,495.41	Facility		$1,659.59	$2,041.74	$5,495.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80
United Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $933.25 / $933.25	Facility		$794.33	$933.25	$933.25
United Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Professional		$1,698.24	$1,698.24	$1,698.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34