Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $437.00 / $2,080.00 / $6,762.00	Facility		$437.00	$2,080.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $202.03 / $247.10 / $382.47	Facility	54	$202.03	$247.10	$382.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.06 / $336.31 / $553.24	Professional		$276.06	$336.31	$553.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $356.97 / $356.97 / $356.97	Professional		$356.97	$356.97	$356.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.41 / $349.34 / $782.24	Facility		$193.41	$349.34	$782.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $297.02 / $375.96 / $543.55	Professional		$297.02	$375.96	$543.55
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $326.17 / $326.17	Facility		$80.00	$326.17	$326.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $542.54 / $542.54 / $542.54	Facility		$542.54	$542.54	$542.54
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $379.78 / $379.78 / $379.78	Facility	54	$379.78	$379.78	$379.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.16 / $424.13 / $651.16	Professional		$319.16	$424.13	$651.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,535.12 / $11,500.00 / $12,000.00	Facility		$1,535.12	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,053.30 / $1,193.36 / $1,193.36	Facility	54	$1,053.30	$1,193.36	$1,193.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,364.32 / $2,708.08 / $3,151.50	Professional		$2,364.32	$2,708.08	$3,151.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $297.89 / $379.24 / $609.96	Facility		$297.89	$379.24	$609.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $414.76 / $504.92 / $643.78	Professional		$414.76	$504.92	$643.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $385.93 / $520.79 / $842.94	Professional		$385.93	$520.79	$842.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $298.42 / $380.71 / $628.83	Facility		$298.42	$380.71	$628.83
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $379.78 / $379.78 / $679.66	Facility	54	$379.78	$379.78	$679.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $327.33 / $448.93 / $693.12	Professional		$327.33	$448.93	$693.12
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 $267.39 / $358.01 / $553.84	Professional		$267.39	$358.01	$553.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $307.81 / $346.05 / $487.38	Professional		$307.81	$346.05	$487.38