Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $504.25 / $2,071.00 / $6,303.64	Facility		$504.25	$2,071.00	$6,303.64
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $311.27 / $374.11 / $588.22	Facility	54	$311.27	$374.11	$588.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $454.91 / $508.86 / $856.11	Professional		$454.91	$508.86	$856.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $337.95 / $579.90 / $851.48	Professional		$337.95	$579.90	$851.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,252.15 / $2,155.07 / $4,337.25	Facility		$1,252.15	$2,155.07	$4,337.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $460.16 / $582.09 / $821.11	Professional		$460.16	$582.09	$821.11
Christus Facility/Professional Facility Modifier Low / Median / High Price $485.91 / $655.37 / $655.37	Facility		$485.91	$655.37	$655.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $842.02 / $842.02 / $842.02	Facility		$842.02	$842.02	$842.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $589.41 / $589.41 / $589.41	Facility	54	$589.41	$589.41	$589.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $509.73 / $676.40 / $1,034.83	Professional		$509.73	$676.40	$1,034.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,344.88 / $11,500.00 / $12,000.00	Facility		$2,344.88	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,610.71 / $1,780.60 / $1,780.60	Facility	54	$1,610.71	$1,780.60	$1,780.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,609.44 / $4,043.60 / $4,707.14	Professional		$3,609.44	$4,043.60	$4,707.14
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $490.58 / $629.12 / $966.31	Facility		$490.58	$629.12	$966.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $626.88 / $754.00 / $969.43	Professional		$626.88	$754.00	$969.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $588.24 / $935.77 / $1,913.20	Professional		$588.24	$935.77	$1,913.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $490.58 / $636.19 / $1,017.81	Facility		$490.58	$636.19	$1,017.81
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $589.41 / $589.41 / $1,031.70	Facility	54	$589.41	$589.41	$1,031.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $512.20 / $711.18 / $1,067.50	Professional		$512.20	$711.18	$1,067.50
United Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $2,100.00 / $4,554.00	Facility		$600.00	$2,100.00	$4,554.00
United Facility/Professional Professional Modifier Low / Median / High Price $417.38 / $573.62 / $909.93	Professional		$417.38	$573.62	$909.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $459.65 / $519.65 / $726.04	Professional		$459.65	$519.65	$726.04