Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $405.17 / $1,964.00 / $6,691.00	Facility		$405.17	$1,964.00	$6,691.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.90 / $297.80 / $465.26	Facility	54	$245.90	$297.80	$465.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $359.14 / $418.27 / $685.81	Professional		$359.14	$418.27	$685.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $720.95 / $720.95 / $720.95	Professional		$720.95	$720.95	$720.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.41 / $347.18 / $790.83	Facility		$193.41	$347.18	$790.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.90 / $459.34 / $654.98	Professional		$362.90	$459.34	$654.98
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $401.54 / $404.03	Facility		$80.00	$401.54	$404.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $664.33 / $664.33 / $664.33	Facility		$664.33	$664.33	$664.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $465.03 / $465.03 / $465.03	Facility	54	$465.03	$465.03	$465.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $401.57 / $529.41 / $814.78	Professional		$401.57	$529.41	$814.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,858.84 / $11,500.00 / $12,000.00	Facility		$1,858.84	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,275.83 / $1,422.04 / $1,422.04	Facility	54	$1,275.83	$1,422.04	$1,422.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,865.60 / $3,238.80 / $3,762.75	Professional		$2,865.60	$3,238.80	$3,762.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $370.74 / $494.40 / $771.44	Facility		$370.74	$494.40	$771.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $496.55 / $603.65 / $769.66	Professional		$496.55	$603.65	$769.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $472.45 / $750.56 / $1,519.21	Professional		$472.45	$750.56	$1,519.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $370.74 / $498.30 / $793.53	Facility		$370.74	$498.30	$793.53
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $465.03 / $465.03 / $820.34	Facility	54	$465.03	$465.03	$820.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $405.88 / $560.78 / $858.47	Professional		$405.88	$560.78	$858.47
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 $330.49 / $440.65 / $696.23	Professional		$330.49	$440.65	$696.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $368.00 / $415.40 / $581.91	Professional		$368.00	$415.40	$581.91