Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,041.56 / $4,142.60 / $15,196.30	Facility		$4,041.56	$4,142.60	$15,196.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,041.56 / $4,142.60 / $4,294.16	Professional		$4,041.56	$4,142.60	$4,294.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,294.16 / $4,294.16 / $4,294.16	Facility		$4,294.16	$4,294.16	$4,294.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,294.16 / $4,294.16 / $4,294.16	Professional		$4,294.16	$4,294.16	$4,294.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,007.77 / $10,103.90 / $18,944.81	Facility		$6,007.77	$10,103.90	$18,944.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $17,681.83 / $19,197.41 / $22,733.78	Professional		$17,681.83	$19,197.41	$22,733.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $4,142.60 / $5,051.95 / $9,015.20	Facility		$4,142.60	$5,051.95	$9,015.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $4,390.39 / $4,390.39 / $4,390.39	Professional		$4,390.39	$4,390.39	$4,390.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $4,193.12 / $5,051.95 / $6,863.07	Facility		$4,193.12	$5,051.95	$6,863.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $4,294.16 / $4,294.16 / $4,294.16	Professional		$4,294.16	$4,294.16	$4,294.16
United Facility/Professional Professional Modifier Low / Median / High Price $4,209.96 / $4,209.96 / $4,298.37	Professional		$4,209.96	$4,209.96	$4,298.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $4,209.96 / $4,799.35 / $6,479.12	Professional		$4,209.96	$4,799.35	$6,479.12