Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $474.00 / $2,128.00 / $7,513.00	Facility		$474.00	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $303.05 / $339.35 / $565.05	Facility	54	$303.05	$339.35	$565.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $421.18 / $489.68 / $780.46	Professional		$421.18	$489.68	$780.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $444.89 / $560.55 / $774.74	Professional		$444.89	$560.55	$774.74
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $459.20 / $463.57	Facility		$80.00	$459.20	$463.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $818.60 / $818.60 / $818.60	Facility		$818.60	$818.60	$818.60
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $573.02 / $573.02 / $573.02	Facility	54	$573.02	$573.02	$573.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.73 / $625.85 / $970.62	Professional		$478.73	$625.85	$970.62
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,798.50 / $11,500.00 / $12,000.00	Facility		$2,798.50	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,570.45 / $1,744.73 / $1,744.73	Facility	54	$1,570.45	$1,744.73	$1,744.73
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,520.80 / $3,665.28 / $4,262.39	Professional		$3,520.80	$3,665.28	$4,262.39
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $448.78 / $566.17 / $885.08	Facility		$448.78	$566.17	$885.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $599.23 / $719.07 / $891.65	Professional		$599.23	$719.07	$891.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $546.24 / $824.19 / $1,097.53	Professional		$546.24	$824.19	$1,097.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $451.92 / $575.29 / $916.69	Facility		$451.92	$575.29	$916.69
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $573.02 / $573.02 / $935.98	Facility	54	$573.02	$573.02	$935.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $487.52 / $647.72 / $997.29	Professional		$487.52	$647.72	$997.29
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 $375.96 / $519.30 / $802.57	Professional		$375.96	$519.30	$802.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.31 / $470.88 / $657.49	Professional		$416.31	$470.88	$657.49