Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $22.91 / $27.54	Facility		$14.13	$22.91	$27.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Professional		$15.14	$15.14	$15.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $21.88 / $22.91	Facility		$14.13	$21.88	$22.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $15.14 / $15.14	Professional		$15.14	$15.14	$15.14
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95