Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $746.74 / $1,450.98 / $2,807.74	Facility		$746.74	$1,450.98	$2,807.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $746.74 / $765.41 / $793.42	Professional		$746.74	$765.41	$793.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $64.56 / $163.40 / $326.02	Facility		$64.56	$163.40	$326.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $793.42 / $793.42 / $793.42	Facility		$793.42	$793.42	$793.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $793.42 / $793.42 / $793.42	Professional		$793.42	$793.42	$793.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $886.76 / $3,547.04 / $3,547.04	Facility		$886.76	$3,547.04	$3,547.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,547.03 / $3,547.03 / $4,200.43	Professional		$3,547.03	$3,547.03	$4,200.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $765.41 / $933.43 / $1,665.71	Facility		$765.41	$933.43	$1,665.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $793.42 / $933.43 / $1,268.07	Facility		$793.42	$933.43	$1,268.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $793.42 / $793.42 / $793.42	Professional		$793.42	$793.42	$793.42
United Facility/Professional Professional Modifier Low / Median / High Price $777.86 / $777.86 / $787.97	Professional		$777.86	$777.86	$787.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $777.86 / $886.76 / $1,197.13	Professional		$777.86	$886.76	$1,197.13