Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $375.20 / $2,128.00 / $7,513.00	Facility		$375.20	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $151.47 / $167.76 / $281.39	Facility	54	$151.47	$167.76	$281.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.12 / $240.89 / $417.02	Professional		$201.12	$240.89	$417.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.08 / $355.81 / $769.83	Facility		$194.08	$355.81	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.16 / $279.70 / $387.56	Professional		$223.16	$279.70	$387.56
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $248.15 / $248.15	Facility		$80.00	$248.15	$248.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $409.29 / $409.29 / $409.29	Facility		$409.29	$409.29	$409.29
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $286.50 / $286.50 / $286.50	Facility	54	$286.50	$286.50	$286.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.54 / $299.17 / $466.57	Professional		$230.54	$299.17	$466.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,416.85 / $11,500.00 / $12,000.00	Facility		$1,416.85	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $793.71 / $896.72 / $896.72	Facility	54	$793.71	$896.72	$896.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,779.28 / $1,833.36 / $2,133.30	Professional		$1,779.28	$1,833.36	$2,133.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $214.50 / $273.14 / $433.69	Facility		$214.50	$273.14	$433.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $286.08 / $363.42 / $450.64	Professional		$286.08	$363.42	$450.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $290.66 / $460.71 / $930.23	Professional		$290.66	$460.71	$930.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $216.44 / $275.31 / $449.46	Facility		$216.44	$275.31	$449.46
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $286.50 / $286.50 / $461.89	Facility	54	$286.50	$286.50	$461.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $235.30 / $313.51 / $480.00	Professional		$235.30	$313.51	$480.00
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 $177.45 / $238.29 / $372.39	Professional		$177.45	$238.29	$372.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.15 / $234.50 / $329.18	Professional		$208.15	$234.50	$329.18