Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,047.13 / $1,071.52	Professional		$691.83	$1,047.13	$1,071.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,148.15 / $4,265.80	Facility		$891.25	$1,148.15	$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 $602.56 / $602.56 / $602.56	Professional		$602.56	$602.56	$602.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility		$1,905.46	$1,905.46	$1,905.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,479.11 / $1,479.11	Professional		$1,148.15	$1,479.11	$1,479.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,047.13 / $2,290.87	Facility		$724.44	$1,047.13	$2,290.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,047.13 / $1,047.13	Professional		$691.83	$1,047.13	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $524.81	Professional		$309.03	$436.52	$524.81
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 $724.44 / $1,047.13 / $2,344.23	Facility		$724.44	$1,047.13	$2,344.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $602.56	Professional		$60.26	$79.43	$602.56
United Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $776.25 / $1,023.29	Facility		$371.54	$776.25	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $707.95	Professional		$707.95	$707.95	$707.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $616.60 / $776.25	Professional		$457.09	$616.60	$776.25