Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $382.00 / $2,000.00 / $6,762.00	Facility		$382.00	$2,000.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $182.89 / $214.75 / $348.37	Facility	54	$182.89	$214.75	$348.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.78 / $302.18 / $526.41	Professional		$252.78	$302.18	$526.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $601.47 / $601.47 / $601.47	Professional		$601.47	$601.47	$601.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.82 / $167.03 / $666.84	Facility		$95.82	$167.03	$666.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.94 / $341.68 / $476.04	Professional		$269.94	$341.68	$476.04
Christus Facility/Professional Facility Modifier Low / Median / High Price $97.48 / $97.48 / $281.62	Facility		$97.48	$97.48	$281.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $495.31 / $495.31 / $495.31	Facility		$495.31	$495.31	$495.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $346.72 / $346.72 / $346.72	Facility	54	$346.72	$346.72	$346.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.26 / $384.27 / $587.91	Professional		$288.26	$384.27	$587.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,541.95	Facility		$55.00	$55.00	$1,541.95
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $957.94 / $1,079.36 / $1,079.36	Facility	54	$957.94	$1,079.36	$1,079.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,151.28 / $2,350.08 / $2,745.38	Professional		$2,151.28	$2,350.08	$2,745.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $267.75 / $347.68 / $552.05	Facility		$267.75	$347.68	$552.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $368.80 / $440.17 / $561.22	Professional		$368.80	$440.17	$561.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $343.87 / $525.08 / $1,127.02	Professional		$343.87	$525.08	$1,127.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $269.63 / $349.18 / $569.37	Facility		$269.63	$349.18	$569.37
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $346.72 / $346.72 / $591.01	Facility	54	$346.72	$346.72	$591.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $297.70 / $405.45 / $619.71	Professional		$297.70	$405.45	$619.71
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 $237.38 / $317.72 / $503.96	Professional		$237.38	$317.72	$503.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $268.33 / $302.30 / $424.60	Professional		$268.33	$302.30	$424.60