Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $4,073.80 / $14,454.40	Facility		$1,174.90	$4,073.80	$14,454.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,290.87 / $9,772.37	Facility		$1,348.96	$2,290.87	$9,772.37
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $1,230.27 / $1,288.25	Facility		$79.43	$1,230.27	$1,288.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $5,011.87 / $16,218.10	Facility		$5,011.87	$5,011.87	$16,218.10
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $10,232.93 / $10,232.93 / $10,232.93	Facility	62	$10,232.93	$10,232.93	$10,232.93
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $1,621.81 / $1,621.81 / $1,621.81	Facility	AS	$1,621.81	$1,621.81	$1,621.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,737.80 / $5,011.87	Facility		$1,202.26	$1,737.80	$5,011.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,621.81 / $3,019.95	Facility		$1,258.93	$1,621.81	$3,019.95
Providence Facility/Professional Facility Modifier 22 Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility	22	$2,691.53	$2,691.53	$2,691.53
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	62	$1,380.38	$1,380.38	$1,380.38
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	AS	$223.87	$223.87	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $4,570.88 / $10,964.78 / $30,199.52	Facility		$4,570.88	$10,964.78	$30,199.52