Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $169.82 / $186.21	Facility		$165.96	$169.82	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $218.78	Professional		$134.90	$186.21	$218.78
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 $1,318.26 / $1,995.26 / $1,995.26	Professional		$1,318.26	$1,995.26	$1,995.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $208.93 / $389.05	Facility		$141.25	$208.93	$389.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $218.78	Professional		$154.88	$186.21	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $50.12	Professional		$30.20	$30.20	$50.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $204.17 / $371.54	Facility		$141.25	$204.17	$371.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $190.55 / $338.84	Professional		$60.26	$190.55	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $251.19	Professional		$131.83	$181.97	$251.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $316.23	Professional		$173.78	$173.78	$316.23