Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $1,663.50	Professional		$1,663.50	$1,663.50	$1,663.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.71 / $386.71 / $386.71	Professional		$386.71	$386.71	$386.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,996.00 / $3,996.00 / $3,996.00	Facility		$3,996.00	$3,996.00	$3,996.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,915.00 / $3,996.00 / $4,893.75	Professional		$3,915.00	$3,996.00	$4,893.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $80.00 / $100.00	Facility		$65.00	$80.00	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $1,663.50	Facility		$1,663.50	$1,663.50	$1,663.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $1,663.50	Professional		$1,663.50	$1,663.50	$1,663.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,663.50 / $1,663.50 / $3,996.00	Facility		$1,663.50	$1,663.50	$3,996.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,663.50 / $3,996.00 / $3,996.00	Professional		$1,663.50	$3,996.00	$3,996.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,109.00 / $1,565.64 / $4,425.89	Professional		$1,109.00	$1,565.64	$4,425.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,912.10 / $3,473.99 / $3,473.99	Professional		$2,912.10	$3,473.99	$3,473.99