Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.80 / $150.65 / $338.40	Facility		$61.80	$150.65	$338.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $62.41 / $68.65	Professional		$61.80	$62.41	$68.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.40 / $169.98 / $335.32	Facility		$66.40	$169.98	$335.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.43 / $98.43 / $98.43	Professional		$98.43	$98.43	$98.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.28 / $61.80 / $61.80	Facility		$55.28	$61.80	$61.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $61.80 / $61.80	Professional		$61.80	$61.80	$61.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $271.20 / $747.02 / $747.02	Facility		$271.20	$747.02	$747.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $62.15 / $88.37 / $91.02	Facility		$62.15	$88.37	$91.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.38 / $61.80 / $306.25	Professional		$58.38	$61.80	$306.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $55.28 / $61.80 / $91.02	Facility		$55.28	$61.80	$91.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $61.80 / $67.05	Professional		$61.80	$61.80	$67.05
United Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $61.80 / $61.80	Professional		$61.80	$61.80	$61.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $83.43 / $169.20	Professional		$61.80	$83.43	$169.20