Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $3,682.00 / $12,826.00	Facility		$921.00	$3,682.00	$12,826.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $791.37 / $903.20 / $1,534.41	Professional		$791.37	$903.20	$1,534.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $807.56 / $807.56 / $807.56	Professional		$807.56	$807.56	$807.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $800.55 / $1,687.67 / $3,233.23	Facility		$800.55	$1,687.67	$3,233.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $821.83 / $1,040.23 / $1,417.50	Professional		$821.83	$1,040.23	$1,417.50
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $791.02 / $809.18	Facility		$80.00	$791.02	$809.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,009.63 / $1,009.63 / $1,009.63	Facility		$1,009.63	$1,009.63	$1,009.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $904.14 / $1,217.80 / $1,851.98	Professional		$904.14	$1,217.80	$1,851.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $6,113.52	Facility		$55.00	$55.00	$6,113.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,643.43 / $6,862.66 / $7,657.13	Professional		$6,643.43	$6,862.66	$7,657.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,216.05 / $1,930.73	Facility		$870.96	$1,216.05	$1,930.73
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,094.53 / $1,313.43 / $1,628.65	Professional		$1,094.53	$1,313.43	$1,628.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $949.96 / $1,514.92 / $3,255.73	Professional		$949.96	$1,514.92	$3,255.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $1,216.53 / $1,953.92	Facility		$870.96	$1,216.53	$1,953.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $914.09 / $1,266.57 / $1,895.88	Professional		$914.09	$1,266.57	$1,895.88
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $6,000.00 / $13,134.00	Facility		$2,093.00	$6,000.00	$13,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $719.14 / $966.12 / $1,540.86	Professional		$719.14	$966.12	$1,540.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $747.32 / $850.06 / $1,177.17	Professional		$747.32	$850.06	$1,177.17