Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $361.44 / $2,107.00 / $6,762.00	Facility		$361.44	$2,107.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $183.89 / $217.82 / $347.56	Facility	54	$183.89	$217.82	$347.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.29 / $304.57 / $534.00	Professional		$250.29	$304.57	$534.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.32 / $198.79 / $325.91	Professional		$171.32	$198.79	$325.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.92 / $360.12 / $769.83	Facility		$191.92	$360.12	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.94 / $340.63 / $478.31	Professional		$269.94	$340.63	$478.31
Christus Facility/Professional Facility Modifier Low / Median / High Price $1.77 / $1.77 / $288.33	Facility		$1.77	$1.77	$288.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $493.23 / $493.23 / $493.23	Facility		$493.23	$493.23	$493.23
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $345.26 / $345.26 / $345.26	Facility	54	$345.26	$345.26	$345.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.75 / $380.35 / $587.88	Professional		$287.75	$380.35	$587.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,390.80 / $11,500.00 / $12,000.00	Facility		$1,390.80	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $956.89 / $1,083.52 / $1,083.52	Facility	54	$956.89	$1,083.52	$1,083.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,149.36 / $2,375.12 / $2,771.03	Professional		$2,149.36	$2,375.12	$2,771.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $267.24 / $343.09 / $548.16	Facility		$267.24	$343.09	$548.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $372.22 / $444.25 / $566.41	Professional		$372.22	$444.25	$566.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $348.98 / $553.03 / $1,134.45	Professional		$348.98	$553.03	$1,134.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $268.12 / $347.79 / $569.38	Facility		$268.12	$347.79	$569.38
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $345.26 / $345.26 / $599.36	Facility	54	$345.26	$345.26	$599.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $296.22 / $405.29 / $618.10	Professional		$296.22	$405.29	$618.10
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 $238.19 / $322.60 / $505.22	Professional		$238.19	$322.60	$505.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $270.82 / $304.70 / $428.75	Professional		$270.82	$304.70	$428.75