Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $657.00 / $1,841.25	Facility		$225.00	$657.00	$1,841.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.00 / $277.50 / $318.75	Professional		$225.00	$277.50	$318.75
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $80.00	Facility		$80.00	$80.00	$80.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $249.80 / $823.88 / $1,671.38	Facility		$249.80	$823.88	$1,671.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $414.59 / $496.73	Professional		$180.00	$414.59	$496.73
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $1,781.25 / $1,781.25	Facility		$600.00	$1,781.25	$1,781.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $2,812.50	Professional		$1,875.00	$1,875.00	$2,812.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $375.00 / $525.45	Facility		$225.00	$375.00	$525.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $356.25 / $375.00 / $468.75	Professional		$356.25	$375.00	$468.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $337.50 / $468.75 / $843.75	Professional		$337.50	$468.75	$843.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $254.72 / $402.19 / $1,351.04	Facility		$254.72	$402.19	$1,351.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $219.38 / $450.00 / $540.00	Professional		$219.38	$450.00	$540.00
United Facility/Professional Professional Modifier Low / Median / High Price $157.50 / $157.50 / $240.00	Professional		$157.50	$157.50	$240.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $375.00	Professional		$150.00	$150.00	$375.00