Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $151.36	Facility		$79.43	$79.43	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $89.13	Professional		$79.43	$79.43	$89.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $4,265.80	Facility		$147.91	$147.91	$4,265.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $109.65	Facility		$102.33	$102.33	$109.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $85.11 / $169.82	Facility		$79.43	$85.11	$169.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $89.13	Professional		$79.43	$79.43	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $60.26	Professional		$38.02	$50.12	$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 $79.43 / $85.11 / $173.78	Facility		$79.43	$85.11	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $77.62 / $79.43	Professional		$60.26	$77.62	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $204.17 / $269.15	Facility		$117.49	$204.17	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $79.43	Professional		$40.74	$40.74	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $74.13 / $93.33	Professional		$30.20	$74.13	$93.33