Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.06 / $2,017.00 / $6,762.00	Facility		$331.06	$2,017.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $197.48 / $235.91 / $372.20	Facility	54	$197.48	$235.91	$372.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.62 / $323.93 / $546.14	Professional		$273.62	$323.93	$546.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $402.75 / $402.75 / $402.75	Professional		$402.75	$402.75	$402.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.45 / $400.44 / $692.20	Facility		$208.45	$400.44	$692.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.33 / $366.22 / $517.46	Professional		$289.33	$366.22	$517.46
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $309.33 / $309.33	Facility		$80.00	$309.33	$309.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.16 / $528.16 / $528.16	Facility		$528.16	$528.16	$528.16
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $369.72	Facility	54	$369.72	$369.72	$369.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.94 / $416.72 / $636.78	Professional		$313.94	$416.72	$636.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,492.48 / $11,500.00 / $12,000.00	Facility		$1,492.48	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,024.70 / $1,160.82 / $1,160.82	Facility	54	$1,024.70	$1,160.82	$1,160.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,302.71 / $2,579.60 / $3,001.65	Professional		$2,302.71	$2,579.60	$3,001.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $291.64 / $379.64 / $602.91	Facility		$291.64	$379.64	$602.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $398.81 / $481.38 / $613.75	Professional		$398.81	$481.38	$613.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $375.52 / $594.48 / $1,226.33	Professional		$375.52	$594.48	$1,226.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $292.73 / $382.29 / $618.03	Facility		$292.73	$382.29	$618.03
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $648.82	Facility	54	$369.72	$369.72	$648.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $322.42 / $442.08 / $666.87	Professional		$322.42	$442.08	$666.87
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 $259.04 / $356.58 / $546.41	Professional		$259.04	$356.58	$546.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $293.45 / $330.12 / $464.67	Professional		$293.45	$330.12	$464.67