Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $398.11	Facility		$363.08	$363.08	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $371.54 / $512.86	Professional		$89.13	$371.54	$512.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,090.30	Facility		$3,090.30	$3,090.30	$3,090.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $4,897.79 / $4,897.79	Professional		$3,162.28	$4,897.79	$4,897.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $398.11 / $851.14	Facility		$70.79	$398.11	$851.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $380.19 / $501.19	Professional		$95.50	$380.19	$501.19
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 $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $363.08 / $870.96	Facility		$70.79	$363.08	$870.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $120.23 / $741.31	Professional		$60.26	$120.23	$741.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $177.83	Professional		$144.54	$144.54	$177.83