Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $410.46 / $2,128.00 / $7,513.00	Facility		$410.46	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $167.84 / $190.46 / $317.47	Facility	54	$167.84	$190.46	$317.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.19 / $269.39 / $476.87	Professional		$231.19	$269.39	$476.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.88 / $172.40 / $648.30	Facility		$95.88	$172.40	$648.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.86 / $311.50 / $433.90	Professional		$246.86	$311.50	$433.90
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $262.48 / $262.48	Facility		$80.00	$262.48	$262.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.36 / $450.36 / $450.36	Facility		$450.36	$450.36	$450.36
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $315.25 / $315.25 / $315.25	Facility	54	$315.25	$315.25	$315.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.14 / $345.54 / $532.27	Professional		$263.14	$345.54	$532.27
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,588.00	Facility		$55.00	$55.00	$1,588.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $874.23 / $990.65 / $990.65	Facility	54	$874.23	$990.65	$990.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,963.28 / $2,084.23 / $2,435.33	Professional		$1,963.28	$2,084.23	$2,435.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $241.16 / $315.70 / $489.53	Facility		$241.16	$315.70	$489.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $333.58 / $400.29 / $497.71	Professional		$333.58	$400.29	$497.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $321.47 / $502.50 / $1,053.75	Professional		$321.47	$502.50	$1,053.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $243.91 / $319.14 / $513.72	Facility		$243.91	$319.14	$513.72
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $315.25 / $315.25 / $524.20	Facility	54	$315.25	$315.25	$524.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $268.12 / $357.67 / $551.42	Professional		$268.12	$357.67	$551.42
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 $208.69 / $279.83 / $439.39	Professional		$208.69	$279.83	$439.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $237.97 / $267.85 / $376.66	Professional		$237.97	$267.85	$376.66