Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $93.84 / $199.75	Facility		$83.23	$93.84	$199.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.23 / $85.31 / $116.02	Professional		$83.23	$85.31	$116.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.33 / $338.13 / $495.92	Facility		$167.33	$338.13	$495.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Facility		$88.43	$88.43	$88.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $111.83 / $437.90 / $437.90	Facility		$111.83	$437.90	$437.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $91.90 / $121.99	Facility		$83.23	$91.90	$121.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.58 / $78.03 / $143.06	Professional		$74.58	$78.03	$143.06
Providence Facility/Professional Facility Modifier Low / Median / High Price $88.43 / $88.43 / $121.99	Facility		$88.43	$88.43	$121.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $88.43 / $118.41	Professional		$78.03	$88.43	$118.41
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Professional		$86.70	$86.70	$86.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $117.05	Professional		$86.70	$86.70	$117.05