Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $245.47 / $263.03	Facility		$239.88	$245.47	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $338.84	Professional		$223.87	$269.15	$338.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Professional		$1,148.15	$1,148.15	$1,148.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,754.23 / $2,754.23	Professional		$1,905.46	$2,754.23	$2,754.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $346.74 / $575.44	Facility		$251.19	$346.74	$575.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $302.00	Professional		$223.87	$269.15	$302.00
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 $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $331.13 / $524.81	Facility		$245.47	$331.13	$524.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $309.03 / $489.78	Professional		$60.26	$309.03	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $549.54	Professional		$436.52	$436.52	$549.54