Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $119.70 / $119.70	Professional		$119.70	$119.70	$119.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.50 / $94.50 / $94.50	Facility		$94.50	$94.50	$94.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $94.50 / $150.55	Professional		$80.33	$94.50	$150.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $100.00 / $134.96	Facility		$65.00	$100.00	$134.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $119.70 / $119.70 / $119.70	Facility		$119.70	$119.70	$119.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $132.34 / $132.34	Professional		$119.70	$132.34	$132.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $94.50 / $119.70 / $119.70	Facility		$94.50	$119.70	$119.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $94.50 / $150.55	Professional		$80.33	$94.50	$150.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Professional		$150.00	$150.00	$150.00