Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $218.78 / $239.88	Facility		$213.80	$218.78	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $316.23	Professional		$204.17	$245.47	$316.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Facility		$1,698.24	$1,698.24	$1,698.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,398.83 / $2,398.83	Professional		$1,698.24	$2,398.83	$2,398.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $309.03 / $524.81	Facility		$229.09	$309.03	$524.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $281.84	Professional		$204.17	$245.47	$281.84
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 $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $309.03 / $501.19	Facility		$229.09	$309.03	$501.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $269.15 / $436.52	Professional		$60.26	$269.15	$436.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $851.14	Professional		$380.19	$380.19	$851.14