Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.20 / $336.38 / $993.72	Facility		$115.20	$336.38	$993.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.52 / $126.72 / $153.60	Professional		$107.52	$126.72	$153.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $384.00 / $384.00	Professional		$384.00	$384.00	$384.00
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 $124.80 / $763.78 / $1,710.63	Facility		$124.80	$763.78	$1,710.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $467.55 / $467.55 / $560.17	Professional		$467.55	$467.55	$560.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $614.40 / $1,824.00 / $1,824.00	Facility		$614.40	$1,824.00	$1,824.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,912.32 / $1,912.32 / $2,880.00	Professional		$1,912.32	$1,912.32	$2,880.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $117.12 / $283.45 / $499.20	Facility		$117.12	$283.45	$499.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $391.68 / $576.00	Professional		$192.00	$391.68	$576.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $345.60 / $480.00 / $864.00	Professional		$345.60	$480.00	$864.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.57 / $326.98 / $1,159.92	Facility		$128.57	$326.98	$1,159.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.80 / $240.00 / $460.80	Professional		$172.80	$240.00	$460.80
United Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $80.64 / $158.86	Professional		$80.64	$80.64	$158.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $74.88 / $384.00	Professional		$33.47	$74.88	$384.00