Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $382.00 / $2,128.00 / $7,513.00	Facility		$382.00	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $151.46 / $169.94 / $287.93	Facility	54	$151.46	$169.94	$287.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.93 / $240.94 / $416.48	Professional		$201.93	$240.94	$416.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.81 / $240.62 / $250.36	Professional		$158.81	$240.62	$250.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.08 / $366.59 / $752.15	Facility		$194.08	$366.59	$752.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.54 / $278.11 / $386.73	Professional		$222.54	$278.11	$386.73
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $244.36 / $244.36	Facility		$80.00	$244.36	$244.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $278.24 / $278.24 / $278.24	Facility		$278.24	$278.24	$278.24
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $192.34 / $192.34 / $192.34	Facility	54	$192.34	$192.34	$192.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.52 / $308.81 / $480.14	Professional		$237.52	$308.81	$480.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,373.52 / $11,500.00 / $12,000.00	Facility		$1,373.52	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $395.16 / $792.63 / $895.43	Facility	54	$395.16	$792.63	$895.43
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,776.88 / $1,838.88 / $2,189.85	Professional		$1,776.88	$1,838.88	$2,189.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $216.56 / $276.70 / $431.01	Facility		$216.56	$276.70	$431.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $302.44 / $362.93 / $450.03	Professional		$302.44	$362.93	$450.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $289.13 / $453.67 / $954.17	Professional		$289.13	$453.67	$954.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $216.89 / $278.37 / $452.18	Facility		$216.89	$278.37	$452.18
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $192.34 / $192.34 / $454.18	Facility	54	$192.34	$192.34	$454.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $242.10 / $321.02 / $494.25	Professional		$242.10	$321.02	$494.25
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 $181.08 / $245.99 / $381.33	Professional		$181.08	$245.99	$381.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $206.50 / $232.67 / $326.55	Professional		$206.50	$232.67	$326.55