Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.97 / $432.11 / $1,202.90	Facility		$162.97	$432.11	$1,202.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.28 / $182.72 / $296.30	Professional		$138.28	$182.72	$296.30
Christus Facility/Professional Facility Modifier Low / Median / High Price $246.92 / $246.92 / $246.92	Facility		$246.92	$246.92	$246.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.50 / $491.13 / $1,100.70	Facility		$160.50	$491.13	$1,100.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.87 / $283.73 / $376.35	Professional		$130.87	$283.73	$376.35
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $395.07 / $1,172.86 / $1,172.86	Facility		$395.07	$1,172.86	$1,172.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $172.84 / $246.92 / $298.77	Facility		$172.84	$246.92	$298.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $222.23 / $246.92 / $246.92	Professional		$222.23	$246.92	$246.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $167.72 / $246.92 / $420.51	Facility		$167.72	$246.92	$420.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $130.87 / $234.57 / $259.27	Professional		$130.87	$234.57	$259.27
United Facility/Professional Facility Modifier Low / Median / High Price $103.71 / $246.92 / $296.30	Facility		$103.71	$246.92	$296.30
United Facility/Professional Professional Modifier Low / Median / High Price $103.71 / $103.71 / $148.15	Professional		$103.71	$103.71	$148.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $31.92 / $246.92	Professional		$25.21	$31.92	$246.92