Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,093.00 / $3,774.00 / $13,004.00	Facility		$1,093.00	$3,774.00	$13,004.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $629.45 / $697.67 / $1,158.47	Facility	52	$629.45	$697.67	$1,158.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,574.86 / $2,847.48 / $37,545.36	Facility		$1,574.86	$2,847.48	$37,545.36
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $1,335.84 / $1,370.98	Facility		$80.00	$1,335.84	$1,370.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,723.69 / $1,723.69 / $1,723.69	Facility		$1,723.69	$1,723.69	$1,723.69
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,362.43 / $1,362.43 / $1,362.43	Facility	52	$1,362.43	$1,362.43	$1,362.43
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $170.30 / $170.30 / $170.30	Facility	AS	$170.30	$170.30	$170.30
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $19,057.39	Facility		$55.00	$55.00	$19,057.39
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,732.22 / $5,576.91 / $6,016.39	Facility	52	$2,732.22	$5,576.91	$6,016.39
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $341.53 / $697.11 / $752.05	Facility	AS	$341.53	$697.11	$752.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,477.64 / $1,926.00 / $3,197.89	Facility		$1,477.64	$1,926.00	$3,197.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,477.64 / $1,927.56 / $3,316.50	Facility		$1,477.64	$1,927.56	$3,316.50
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,362.43 / $1,362.43 / $1,362.43	Facility	52	$1,362.43	$1,362.43	$1,362.43
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $579.05 / $579.05 / $579.05	Facility	80	$579.05	$579.05	$579.05
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $170.30 / $170.30 / $492.20	Facility	AS	$170.30	$170.30	$492.20
United Facility/Professional Facility Modifier Low / Median / High Price $4,600.00 / $9,453.00 / $27,388.00	Facility		$4,600.00	$9,453.00	$27,388.00