Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Facility		$524.81	$524.81	$524.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $208.93	Facility		$190.55	$190.55	$208.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $346.74	Professional		$190.55	$190.55	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $288.40	Facility		$190.55	$190.55	$288.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43