Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $402.96 / $1,904.00 / $6,386.00	Facility		$402.96	$1,904.00	$6,386.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $186.98 / $216.69 / $352.11	Facility	54	$186.98	$216.69	$352.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.81 / $319.08 / $538.92	Professional		$265.81	$319.08	$538.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.21 / $328.63 / $347.95	Professional		$189.21	$328.63	$347.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.29 / $345.02 / $769.83	Facility		$191.29	$345.02	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $273.94 / $345.83 / $487.65	Professional		$273.94	$345.83	$487.65
Christus Facility/Professional Facility Modifier Low / Median / High Price $286.64 / $286.64 / $290.94	Facility		$286.64	$286.64	$290.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $498.64 / $498.64 / $498.64	Facility		$498.64	$498.64	$498.64
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $349.05 / $349.05 / $349.05	Facility	54	$349.05	$349.05	$349.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.93 / $404.27 / $621.65	Professional		$298.93	$404.27	$621.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,413.04 / $11,500.00 / $12,000.00	Facility		$1,413.04	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $970.65 / $1,104.80 / $1,104.80	Facility	54	$970.65	$1,104.80	$1,104.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,180.16 / $2,363.92 / $2,754.90	Professional		$2,180.16	$2,363.92	$2,754.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $295.06 / $411.93 / $615.03	Facility		$295.06	$411.93	$615.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $370.36 / $444.44 / $562.95	Professional		$370.36	$444.44	$562.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $361.39 / $569.05 / $1,167.96	Professional		$361.39	$569.05	$1,167.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $295.20 / $413.64 / $629.54	Facility		$295.20	$413.64	$629.54
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $349.05 / $349.05 / $596.14	Facility	54	$349.05	$349.05	$596.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $305.51 / $423.18 / $639.54	Professional		$305.51	$423.18	$639.54
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $949.00 / $2,290.00	Facility		$161.00	$949.00	$2,290.00
United Facility/Professional Professional Modifier Low / Median / High Price $246.34 / $331.92 / $546.45	Professional		$246.34	$331.92	$546.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.17 / $302.56 / $426.25	Professional		$269.17	$302.56	$426.25