Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,819.70 / $1,819.70	Facility		$478.63	$1,819.70	$1,819.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $489.78 / $512.86	Professional		$478.63	$489.78	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $4,365.16 / $4,365.16	Facility		$4,365.16	$4,365.16	$4,365.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Professional		$2,691.53	$2,691.53	$2,691.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $524.81 / $1,071.52	Facility		$478.63	$524.81	$1,071.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $489.78 / $602.56	Professional		$478.63	$489.78	$602.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $602.56 / $1,047.13	Facility		$489.78	$602.56	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Professional		$562.34	$562.34	$562.34