Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $147.91	Facility		$85.11	$85.11	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $194.98	Professional		$85.11	$85.11	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $190.55 / $4,265.80	Facility		$147.91	$190.55	$4,265.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $79.43	Professional		$67.61	$67.61	$79.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Facility		$537.03	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Professional		$630.96	$630.96	$630.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $169.82 / $331.13	Facility		$158.49	$169.82	$331.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $194.98	Professional		$85.11	$85.11	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $75.86	Professional		$51.29	$64.57	$75.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $177.83 / $338.84	Facility		$158.49	$177.83	$338.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $79.43	Professional		$60.26	$79.43	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $81.28 / $107.15	Facility		$60.26	$81.28	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $89.13	Professional		$44.67	$44.67	$89.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $112.20	Professional		$75.86	$89.13	$112.20