Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.81 / $126.81 / $140.58	Facility		$126.81	$126.81	$140.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.34 / $130.52 / $156.29	Professional		$120.34	$130.52	$156.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $295.49 / $919.62 / $919.62	Facility		$295.49	$919.62	$919.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,009.33 / $1,009.33 / $1,462.20	Professional		$1,009.33	$1,009.33	$1,462.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $126.81 / $159.62 / $295.54	Facility		$126.81	$159.62	$295.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $161.76 / $161.76 / $161.76	Professional		$161.76	$161.76	$161.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $126.81 / $160.61 / $300.93	Facility		$126.81	$160.61	$300.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.76 / $175.75 / $259.36	Professional		$161.76	$175.75	$259.36
United Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $232.00 / $428.00	Professional		$86.00	$232.00	$428.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $161.00 / $217.35	Professional		$161.00	$161.00	$217.35