Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,041.74 / $4,073.80	Facility		$1,230.27	$2,041.74	$4,073.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,230.27 / $1,445.44	Professional		$1,174.90	$1,230.27	$1,445.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,754.23 / $5,495.41	Facility		$1,258.93	$2,754.23	$5,495.41
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 $1,318.26 / $1,348.96 / $1,348.96	Facility		$1,318.26	$1,348.96	$1,348.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,659.59	Professional		$1,258.93	$1,258.93	$1,659.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $6,606.93 / $6,606.93	Facility		$6,606.93	$6,606.93	$6,606.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $1,258.93 / $1,995.26	Facility		$44.67	$1,258.93	$1,995.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,230.27 / $1,258.93	Professional		$1,174.90	$1,230.27	$1,258.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Professional		$2,754.23	$2,754.23	$2,754.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $1,258.93 / $1,348.96	Facility		$40.74	$1,258.93	$1,348.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,258.93 / $1,348.96	Professional		$1,122.02	$1,258.93	$1,348.96
United Facility/Professional Facility Modifier Low / Median / High Price $1.26 / $512.86 / $1,202.26	Facility		$1.26	$512.86	$1,202.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $2,137.96	Professional		$1,288.25	$1,288.25	$2,137.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,230.27	Professional		$1,230.27	$1,230.27	$1,230.27