Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $309.03 / $1,258.93	Facility		$57.54	$309.03	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $100.00	Professional		$57.54	$57.54	$100.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $338.84 / $4,265.80	Facility		$263.03	$338.84	$4,265.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $151.36	Professional		$109.65	$109.65	$151.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $63.10 / $134.90	Facility		$58.88	$63.10	$134.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $107.15	Professional		$57.54	$57.54	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $79.43 / $91.20	Professional		$56.23	$79.43	$91.20
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 $58.88 / $64.57 / $128.82	Facility		$58.88	$64.57	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $151.36	Professional		$60.26	$79.43	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $602.56 / $794.33	Facility		$109.65	$602.56	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $81.28 / $138.04	Professional		$16.22	$81.28	$138.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $128.82 / $162.18	Professional		$30.20	$128.82	$162.18