Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $100.00 / $102.33	Facility		$91.20	$100.00	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.15 / $194.98	Professional		$91.20	$107.15	$194.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $3,548.13 / $4,265.80	Facility		$2,884.03	$3,548.13	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $3,715.35 / $3,715.35	Facility		$3,715.35	$3,715.35	$3,715.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,047.13 / $1,047.13	Professional		$724.44	$1,047.13	$1,047.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $128.82 / $234.42	Facility		$95.50	$128.82	$234.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $208.93	Professional		$85.11	$107.15	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $50.12	Professional		$30.20	$30.20	$50.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $123.03 / $223.87	Facility		$95.50	$123.03	$223.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $120.23 / $186.21	Professional		$60.26	$120.23	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $186.21	Professional		$162.18	$173.78	$186.21