Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $4,073.80 / $14,454.40	Facility		$1,258.93	$4,073.80	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,513.56 / $2,290.87	Professional		$1,202.26	$1,513.56	$2,290.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $23,988.33 / $23,988.33 / $23,988.33	Facility		$23,988.33	$23,988.33	$23,988.33
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $12,882.50 / $15,488.17 / $15,488.17	Professional		$12,882.50	$15,488.17	$15,488.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,454.71 / $8,912.51	Facility		$1,230.27	$2,454.71	$8,912.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,479.11 / $2,238.72	Professional		$1,258.93	$1,479.11	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,778.28 / $2,511.89	Facility		$1,288.25	$1,778.28	$2,511.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $20,892.96 / $44,668.36	Facility		$7,585.78	$20,892.96	$44,668.36
United Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,995.26 / $2,818.38	Professional		$1,479.11	$1,995.26	$2,818.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,949.84 / $1,949.84	Professional		$1,819.70	$1,949.84	$1,949.84