Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $100.00 / $724.44	Facility		$54.95	$100.00	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $54.95 / $74.13	Professional		$53.70	$54.95	$74.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $107.15 / $208.93	Facility		$44.67	$107.15	$208.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $54.95 / $54.95	Facility		$51.29	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $60.26 / $131.83	Facility		$54.95	$60.26	$131.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $54.95 / $69.18	Professional		$53.70	$54.95	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $56.23	Professional		$54.95	$54.95	$56.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $77.62 / $173.78	Facility		$54.95	$77.62	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $58.88	Professional		$54.95	$54.95	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95