Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.74 / $37.74 / $41.80	Facility		$37.74	$37.74	$41.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.81 / $41.45 / $47.25	Professional		$35.81	$41.45	$47.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $83.39 / $247.97 / $247.97	Facility		$83.39	$247.97	$247.97
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $300.23 / $300.23 / $394.13	Professional		$300.23	$300.23	$394.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.80 / $58.12 / $96.63	Facility		$41.80	$58.12	$96.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $43.58 / $43.58 / $43.58	Professional		$43.58	$43.58	$43.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.80 / $58.20 / $96.63	Facility		$41.80	$58.20	$96.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.58 / $73.63 / $77.11	Professional		$43.58	$73.63	$77.11
United Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $96.00 / $189.00	Professional		$96.00	$96.00	$189.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $67.00 / $90.45	Professional		$67.00	$67.00	$90.45