Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.60 / $157.44 / $368.64	Facility		$153.60	$157.44	$368.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.60 / $157.44 / $212.84	Professional		$153.60	$157.44	$212.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Facility		$163.19	$163.19	$163.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $192.00 / $830.30 / $831.15	Facility		$192.00	$830.30	$831.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $157.44 / $192.00 / $225.14	Facility		$157.44	$192.00	$225.14
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $144.00 / $144.00	Professional		$144.00	$144.00	$144.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $163.19 / $225.14	Facility		$163.19	$163.19	$225.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
United Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $160.00	Professional		$160.00	$160.00	$160.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $216.00	Professional		$160.00	$160.00	$216.00