Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1.05 / $3.69 / $3.95	Facility		$1.05	$3.69	$3.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1.05 / $1.05 / $1.05	Professional		$1.05	$1.05	$1.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.00 / $245.25 / $521.02	Facility		$109.00	$245.25	$521.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.00 / $109.00 / $109.00	Professional		$109.00	$109.00	$109.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $100.00 / $100.00	Facility		$90.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $42.44 / $42.44	Professional		$42.44	$42.44	$42.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1.05 / $1.50 / $2.98	Facility		$1.05	$1.50	$2.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $1.05 / $1.50 / $2.98	Facility		$1.05	$1.50	$2.98
United Facility/Professional Professional Modifier Low / Median / High Price $54.50 / $65.40 / $109.00	Professional		$54.50	$65.40	$109.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $109.00 / $147.15	Professional		$0.36	$109.00	$147.15