Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $2,128.00 / $7,513.00	Facility		$425.00	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $187.41 / $215.66 / $354.51	Facility	54	$187.41	$215.66	$354.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.15 / $302.29 / $490.93	Professional		$252.15	$302.29	$490.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $372.41 / $372.41 / $372.41	Professional		$372.41	$372.41	$372.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $214.90 / $366.59 / $769.83	Facility		$214.90	$366.59	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.70 / $349.17 / $487.81	Professional		$276.70	$349.17	$487.81
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $282.33 / $285.20	Facility		$80.00	$282.33	$285.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $506.07 / $506.07 / $506.07	Facility		$506.07	$506.07	$506.07
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $354.25	Facility	54	$354.25	$354.25	$354.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.42 / $386.24 / $597.33	Professional		$290.42	$386.24	$597.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.48 / $11,500.00 / $12,000.00	Facility		$1,412.48	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $972.78 / $1,080.72 / $1,080.72	Facility	54	$972.78	$1,080.72	$1,080.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,172.80 / $2,321.92 / $2,722.58	Professional		$2,172.80	$2,321.92	$2,722.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $276.39 / $343.76 / $553.67	Facility		$276.39	$343.76	$553.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $371.18 / $445.41 / $554.29	Professional		$371.18	$445.41	$554.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $328.10 / $361.61 / $522.04	Professional		$328.10	$361.61	$522.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $277.02 / $345.17 / $577.35	Facility		$277.02	$345.17	$577.35
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $594.86	Facility	54	$354.25	$354.25	$594.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $300.45 / $401.92 / $625.63	Professional		$300.45	$401.92	$625.63
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $2,405.00	Facility		$161.00	$950.00	$2,405.00
United Facility/Professional Professional Modifier Low / Median / High Price $239.40 / $326.75 / $505.40	Professional		$239.40	$326.75	$505.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $265.02 / $299.31 / $418.38	Professional		$265.02	$299.31	$418.38