Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $117.49	Facility		$107.15	$107.15	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $208.93	Professional		$107.15	$125.89	$208.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,548.13 / $4,265.80	Facility		$3,162.28	$3,548.13	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $5,011.87 / $5,011.87	Facility		$5,011.87	$5,011.87	$5,011.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,202.26 / $1,202.26	Professional		$851.14	$1,202.26	$1,202.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $154.88 / $257.04	Facility		$114.82	$154.88	$257.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $245.47	Professional		$102.33	$125.89	$245.47
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 $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $151.36 / $251.19	Facility		$114.82	$151.36	$251.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $138.04 / $218.78	Professional		$60.26	$138.04	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $165.96 / $263.03	Professional		$151.36	$165.96	$263.03