Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $538.14 / $2,496.00 / $7,495.00	Facility		$538.14	$2,496.00	$7,495.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $272.48 / $329.20 / $515.67	Facility	54	$272.48	$329.20	$515.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.19 / $460.32 / $754.37	Professional		$398.19	$460.32	$754.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,274.07 / $2,168.62 / $4,838.74	Facility		$1,274.07	$2,168.62	$4,838.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.29 / $509.21 / $729.96	Professional		$402.29	$509.21	$729.96
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $427.27 / $430.35	Facility		$80.00	$427.27	$430.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $736.07 / $736.07 / $736.07	Facility		$736.07	$736.07	$736.07
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $515.25 / $515.25 / $515.25	Facility	54	$515.25	$515.25	$515.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.26 / $584.15 / $892.85	Professional		$441.26	$584.15	$892.85
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,521.40 / $11,500.00 / $16,394.00	Facility		$2,521.40	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,414.67 / $1,575.82 / $1,575.82	Facility	54	$1,414.67	$1,575.82	$1,575.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,170.80 / $3,572.56 / $4,162.28	Professional		$3,170.80	$3,572.56	$4,162.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $427.64 / $546.76 / $852.87	Facility		$427.64	$546.76	$852.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $550.58 / $666.60 / $857.05	Professional		$550.58	$666.60	$857.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $538.14 / $835.52 / $1,721.18	Professional		$538.14	$835.52	$1,721.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $428.70 / $548.41 / $885.65	Facility		$428.70	$548.41	$885.65
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $515.25 / $515.25 / $907.07	Facility	54	$515.25	$515.25	$907.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $448.95 / $620.58 / $937.32	Professional		$448.95	$620.58	$937.32
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,326.00 / $7,600.00	Facility		$1,154.00	$3,326.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $364.06 / $494.62 / $761.79	Professional		$364.06	$494.62	$761.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $406.37 / $458.59 / $642.33	Professional		$406.37	$458.59	$642.33