Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $7,943.28	Facility		$1,202.26	$1,202.26	$7,943.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,513.56	Professional		$1,202.26	$1,202.26	$1,513.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $3,019.95	Facility		$1,202.26	$1,202.26	$3,019.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,513.56 / $1,737.80	Professional		$1,202.26	$1,513.56	$1,737.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,905.46	Facility		$1,202.26	$1,202.26	$1,905.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $79.43	Professional		$60.26	$79.43	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $4,073.80 / $6,165.95	Facility		$389.05	$4,073.80	$6,165.95