Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Facility		$707.95	$707.95	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $1,000.00	Professional		$707.95	$707.95	$1,000.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Professional		$1,258.93	$1,258.93	$1,258.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,548.82	Professional		$1,288.25	$1,288.25	$1,548.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $741.31 / $1,584.89	Facility		$707.95	$741.31	$1,584.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $1,348.96	Professional		$707.95	$707.95	$1,348.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,348.96 / $10,471.29	Professional		$1,000.00	$1,348.96	$10,471.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $758.58 / $1,513.56	Facility		$707.95	$758.58	$1,513.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $79.43	Professional		$60.26	$60.26	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Professional		$676.08	$676.08	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $309.03	Professional		$251.19	$251.19	$309.03