Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $112.19 / $156.34	Facility		$66.64	$112.19	$156.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $67.31 / $98.44	Professional		$66.64	$67.31	$98.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.29 / $212.95 / $424.20	Facility		$82.29	$212.95	$424.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.97 / $82.97 / $82.97	Professional		$82.97	$82.97	$82.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.87 / $66.64 / $66.64	Facility		$62.87	$66.64	$66.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Professional		$66.64	$66.64	$66.64
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $90.77 / $333.20 / $400.46	Facility		$90.77	$333.20	$400.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.91 / $71.66 / $98.16	Facility		$50.91	$71.66	$98.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.75 / $66.64 / $120.78	Professional		$53.75	$66.64	$120.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.68 / $66.64 / $96.25	Facility		$54.68	$66.64	$96.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.97 / $66.64 / $119.35	Professional		$62.97	$66.64	$119.35
United Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Facility		$66.64	$66.64	$66.64
United Facility/Professional Professional Modifier Low / Median / High Price $53.31 / $74.64 / $74.64	Professional		$53.31	$74.64	$74.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $65.94 / $89.96	Professional		$65.94	$65.94	$89.96