Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $223.87 / $346.74	Facility		$77.62	$223.87	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $363.08	Facility		$213.80	$213.80	$363.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $60.26	Professional		$33.88	$47.86	$60.26
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 $213.80 / $234.42 / $426.58	Facility		$213.80	$234.42	$426.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $204.17 / $269.15	Facility		$107.15	$204.17	$269.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $26.30 / $33.11	Professional		$26.30	$26.30	$33.11