Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.60 / $47.60 / $47.60	Facility		$47.60	$47.60	$47.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $30.00	Professional		$25.00	$25.00	$30.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,456.92 / $5,821.21 / $8,577.84	Facility		$5,456.92	$5,821.21	$8,577.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.31 / $2.31 / $2.31	Professional		$2.31	$2.31	$2.31
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $95.00 / $100.00	Facility		$85.00	$95.00	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1.91 / $1.91 / $1.91	Facility		$1.91	$1.91	$1.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $1.58 / $1.58 / $1.91	Facility		$1.58	$1.58	$1.91
United Facility/Professional Professional Modifier Low / Median / High Price $0.20 / $0.27 / $0.28	Professional		$0.20	$0.27	$0.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $0.99 / $0.99 / $1.34	Professional		$0.99	$0.99	$1.34