Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.99 / $2,020.00 / $6,762.00	Facility		$344.99	$2,020.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $156.41 / $185.29 / $299.02	Facility	54	$156.41	$185.29	$299.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.17 / $258.67 / $449.65	Professional		$213.17	$258.67	$449.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $167.03 / $666.84	Facility		$94.80	$167.03	$666.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.54 / $291.81 / $409.55	Professional		$230.54	$291.81	$409.55
Christus Facility/Professional Facility Modifier Low / Median / High Price $183.00 / $183.00 / $245.47	Facility		$183.00	$183.00	$245.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $423.44 / $423.44 / $423.44	Facility		$423.44	$423.44	$423.44
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $296.41 / $296.41 / $296.41	Facility	54	$296.41	$296.41	$296.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.12 / $327.68 / $505.73	Professional		$247.12	$327.68	$505.73
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,340.88	Facility		$55.00	$55.00	$1,340.88
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $824.44 / $938.62 / $938.62	Facility	54	$824.44	$938.62	$938.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,851.68 / $2,044.16 / $2,390.48	Professional		$1,851.68	$2,044.16	$2,390.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $234.90 / $299.74 / $469.52	Facility		$234.90	$299.74	$469.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $320.87 / $385.04 / $488.47	Professional		$320.87	$385.04	$488.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $300.04 / $456.95 / $975.73	Professional		$300.04	$456.95	$975.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $236.45 / $300.52 / $491.80	Facility		$236.45	$300.52	$491.80
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $296.41 / $296.41 / $509.42	Facility	54	$296.41	$296.41	$509.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $252.35 / $345.22 / $526.32	Professional		$252.35	$345.22	$526.32
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 $203.54 / $271.39 / $422.77	Professional		$203.54	$271.39	$422.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $233.55 / $262.43 / $369.91	Professional		$233.55	$262.43	$369.91