Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $407.38 / $1,288.25	Facility		$169.82	$407.38	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $213.80 / $323.59	Professional		$169.82	$213.80	$323.59
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $288.40 / $1,258.93	Facility		$186.21	$288.40	$1,258.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $416.87	Professional		$346.74	$346.74	$416.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,412.54 / $2,137.96 / $2,137.96	Professional		$1,412.54	$2,137.96	$2,137.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $281.84 / $524.81	Facility		$213.80	$281.84	$524.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $338.84	Professional		$169.82	$223.87	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $309.03 / $602.56	Professional		$275.42	$309.03	$602.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $281.84 / $776.25	Facility		$199.53	$281.84	$776.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $295.12 / $489.78	Professional		$79.43	$295.12	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $117.49 / $281.84	Facility		$102.33	$117.49	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $194.98	Professional		$117.49	$117.49	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $281.84 / $281.84	Professional		$251.19	$281.84	$281.84