Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $537.03 / $1,698.24	Facility		$223.87	$537.03	$1,698.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $281.84 / $416.87	Professional		$223.87	$281.84	$416.87
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 $245.47 / $537.03 / $1,659.59	Facility		$245.47	$537.03	$1,659.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $549.54	Professional		$457.09	$457.09	$549.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $1,778.28 / $1,778.28	Facility		$1,778.28	$1,778.28	$1,778.28
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $2,818.38 / $2,818.38	Professional		$1,862.09	$2,818.38	$2,818.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $371.54 / $707.95	Facility		$281.84	$371.54	$707.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $302.00 / $467.74	Professional		$223.87	$302.00	$467.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $407.38 / $794.33	Professional		$371.54	$407.38	$794.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $371.54 / $1,047.13	Facility		$263.03	$371.54	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $416.87 / $660.69	Professional		$338.84	$416.87	$660.69
United Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $158.49 / $371.54	Facility		$134.90	$158.49	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $257.04	Professional		$158.49	$158.49	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $371.54 / $371.54	Professional		$128.82	$371.54	$371.54