Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.32 / $124.63 / $269.20	Facility		$123.32	$124.63	$269.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.22 / $124.55 / $154.66	Professional		$98.22	$124.55	$154.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Facility		$128.69	$128.69	$128.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Professional		$128.69	$128.69	$128.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $300.73 / $858.56 / $858.56	Facility		$300.73	$858.56	$858.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,015.51 / $1,015.51 / $1,323.83	Professional		$1,015.51	$1,015.51	$1,323.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.83 / $259.39 / $348.56	Facility		$154.83	$259.39	$348.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $143.06 / $143.06 / $261.42	Professional		$143.06	$143.06	$261.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $198.67 / $348.56	Facility		$128.69	$198.67	$348.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Professional		$128.69	$128.69	$128.69
United Facility/Professional Professional Modifier Low / Median / High Price $259.31 / $259.31 / $264.76	Professional		$259.31	$259.31	$264.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $158.88 / $214.49 / $275.95	Professional		$158.88	$214.49	$275.95