Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $695.90 / $713.30 / $2,378.73	Facility		$695.90	$713.30	$2,378.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $695.90 / $713.30 / $739.40	Professional		$695.90	$713.30	$739.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.06 / $1,386.43 / $3,017.88	Facility		$203.06	$1,386.43	$3,017.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $664.27 / $664.27 / $664.27	Professional		$664.27	$664.27	$664.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $739.40 / $739.40 / $739.40	Facility		$739.40	$739.40	$739.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $739.40 / $739.40 / $739.40	Professional		$739.40	$739.40	$739.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,055.75 / $1,581.60 / $2,965.50	Facility		$1,055.75	$1,581.60	$2,965.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,005.04 / $3,005.04 / $3,558.60	Professional		$3,005.04	$3,005.04	$3,558.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $713.30 / $790.80 / $1,552.30	Facility		$713.30	$790.80	$1,552.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $695.10 / $695.10 / $695.10	Professional		$695.10	$695.10	$695.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $675.30 / $1,009.47 / $1,059.94	Professional		$675.30	$1,009.47	$1,059.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $722.00 / $869.88 / $1,438.65	Facility		$722.00	$869.88	$1,438.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $739.40 / $739.40 / $739.40	Professional		$739.40	$739.40	$739.40
United Facility/Professional Professional Modifier Low / Median / High Price $71.50 / $85.80 / $143.00	Professional		$71.50	$85.80	$143.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $143.00 / $193.05 / $659.00	Professional		$143.00	$193.05	$659.00