Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $3,774.00 / $13,401.00	Facility		$1,051.00	$3,774.00	$13,401.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,272.50 / $2,107.58 / $7,939.86	Facility		$1,272.50	$2,107.58	$7,939.86
Christus Facility/Professional Facility Modifier Low / Median / High Price $155.06 / $155.06 / $1,217.67	Facility		$155.06	$155.06	$1,217.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,463.39 / $1,463.39 / $1,463.39	Facility		$1,463.39	$1,463.39	$1,463.39
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $908.75 / $908.75 / $908.75	Facility	62	$908.75	$908.75	$908.75
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $145.40 / $145.40 / $145.40	Facility	AS	$145.40	$145.40	$145.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,000.00 / $16,099.93	Facility		$55.00	$5,000.00	$16,099.93
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,765.79 / $3,722.09 / $3,980.62	Facility	62	$1,765.79	$3,722.09	$3,980.62
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $282.52 / $595.54 / $636.90	Facility	AS	$282.52	$595.54	$636.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,213.07 / $1,543.11 / $2,481.29	Facility		$1,213.07	$1,543.11	$2,481.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,213.07 / $1,543.91 / $2,587.54	Facility		$1,213.07	$1,543.91	$2,587.54
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $908.75 / $908.75 / $1,903.61	Facility	62	$908.75	$908.75	$1,903.61
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $487.32 / $487.32 / $487.32	Facility	80	$487.32	$487.32	$487.32
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $145.40 / $145.40 / $414.23	Facility	AS	$145.40	$145.40	$414.23
United Facility/Professional Facility Modifier Low / Median / High Price $4,600.00 / $9,453.00 / $30,113.00	Facility		$4,600.00	$9,453.00	$30,113.00