Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $391.37 / $1,861.00 / $6,691.00	Facility		$391.37	$1,861.00	$6,691.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $165.74 / $200.12 / $316.44	Facility	54	$165.74	$200.12	$316.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.29 / $272.43 / $464.79	Professional		$221.29	$272.43	$464.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $173.25 / $647.07	Facility		$94.80	$173.25	$647.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.39 / $309.33 / $430.98	Professional		$244.39	$309.33	$430.98
Christus Facility/Professional Facility Modifier Low / Median / High Price $224.51 / $224.51 / $263.82	Facility		$224.51	$224.51	$263.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $449.16 / $449.16 / $449.16	Facility		$449.16	$449.16	$449.16
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $314.41 / $314.41 / $314.41	Facility	54	$314.41	$314.41	$314.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.41 / $344.73 / $530.72	Professional		$260.41	$344.73	$530.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,408.57	Facility		$55.00	$55.00	$1,408.57
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $871.06 / $986.00 / $986.00	Facility	54	$871.06	$986.00	$986.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,957.12 / $2,195.76 / $2,561.33	Professional		$1,957.12	$2,195.76	$2,561.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $248.05 / $309.35 / $492.96	Facility		$248.05	$309.35	$492.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $339.01 / $410.73 / $523.67	Professional		$339.01	$410.73	$523.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $317.69 / $490.38 / $1,042.22	Professional		$317.69	$490.38	$1,042.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $248.28 / $311.27 / $511.78	Facility		$248.28	$311.27	$511.78
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $314.41 / $314.41 / $550.54	Facility	54	$314.41	$314.41	$550.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $268.33 / $363.76 / $561.91	Professional		$268.33	$363.76	$561.91
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 $215.70 / $288.61 / $446.40	Professional		$215.70	$288.61	$446.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $250.39 / $281.69 / $396.45	Professional		$250.39	$281.69	$396.45