Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $329.05 / $498.59 / $717.96	Facility		$329.05	$498.59	$717.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $332.34 / $452.05	Professional		$329.05	$332.34	$452.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.43 / $329.05 / $329.05	Facility		$310.43	$329.05	$329.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $329.05	Professional		$329.05	$329.05	$329.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $424.13 / $1,612.35 / $1,645.25	Facility		$424.13	$1,612.35	$1,645.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $329.10 / $470.54 / $484.66	Facility		$329.10	$470.54	$484.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $246.83 / $329.05 / $596.29	Professional		$246.83	$329.05	$596.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $310.43 / $329.05 / $475.25	Facility		$310.43	$329.05	$475.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $310.87 / $329.05 / $575.60	Professional		$310.87	$329.05	$575.60
United Facility/Professional Facility Modifier Low / Median / High Price $318.85 / $318.85 / $318.85	Facility		$318.85	$318.85	$318.85
United Facility/Professional Professional Modifier Low / Median / High Price $329.05 / $329.05 / $329.05	Professional		$329.05	$329.05	$329.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $318.01 / $318.01 / $444.22	Professional		$318.01	$318.01	$444.22