Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $44.67	Professional		$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $81.28	Professional		$64.57	$64.57	$81.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $79.43 / $112.20	Facility		$32.36	$79.43	$112.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Professional		$30.90	$30.90	$30.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $50.12	Professional		$32.36	$33.11	$50.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $102.33 / $120.23	Professional		$89.13	$102.33	$120.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $79.43 / $147.91	Facility		$43.65	$79.43	$147.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $69.18 / $144.54	Professional		$39.81	$69.18	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $56.23 / $93.33	Professional		$26.92	$56.23	$93.33