Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $521.00 / $2,244.00 / $7,513.00	Facility		$521.00	$2,244.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $296.52 / $325.51 / $544.02	Facility	54	$296.52	$325.51	$544.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $418.07 / $478.75 / $790.00	Professional		$418.07	$478.75	$790.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $598.41 / $598.41 / $598.41	Professional		$598.41	$598.41	$598.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $2,141.52 / $4,277.00	Facility		$1,100.00	$2,141.52	$4,277.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $434.09 / $537.47 / $753.88	Professional		$434.09	$537.47	$753.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $444.48 / $449.18	Facility		$80.00	$444.48	$449.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $539.75 / $539.75 / $539.75	Facility		$539.75	$539.75	$539.75
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $375.54 / $375.54 / $375.54	Facility	54	$375.54	$375.54	$375.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $462.26 / $616.91 / $937.57	Professional		$462.26	$616.91	$937.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,225.05 / $11,500.00 / $12,000.00	Facility		$2,225.05	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $761.96 / $3,154.80 / $3,154.80	Facility	54	$761.96	$3,154.80	$3,154.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,446.80 / $3,514.08 / $4,101.45	Professional		$3,446.80	$3,514.08	$4,101.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $449.83 / $552.19 / $870.90	Facility		$449.83	$552.19	$870.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $586.69 / $704.03 / $872.99	Professional		$586.69	$704.03	$872.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $525.16 / $778.61 / $1,050.05	Professional		$525.16	$778.61	$1,050.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $449.83 / $553.00 / $888.74	Facility		$449.83	$553.00	$888.74
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $375.54 / $375.54 / $898.07	Facility	54	$375.54	$375.54	$898.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $469.62 / $634.45 / $964.25	Professional		$469.62	$634.45	$964.25
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 $365.42 / $491.61 / $762.95	Professional		$365.42	$491.61	$762.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $400.58 / $453.35 / $632.48	Professional		$400.58	$453.35	$632.48