Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $424.00 / $2,128.00 / $7,513.00	Facility		$424.00	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $189.20 / $232.53 / $358.29	Facility	54	$189.20	$232.53	$358.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.64 / $319.56 / $541.41	Professional		$271.64	$319.56	$541.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $325.29 / $325.29 / $325.29	Professional		$325.29	$325.29	$325.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.08 / $347.18 / $790.83	Facility		$194.08	$347.18	$790.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.64 / $351.42 / $508.82	Professional		$277.64	$351.42	$508.82
Christus Facility/Professional Facility Modifier Low / Median / High Price $275.08 / $275.08 / $303.29	Facility		$275.08	$275.08	$303.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $509.18 / $509.18 / $509.18	Facility		$509.18	$509.18	$509.18
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $356.43 / $356.43 / $356.43	Facility	54	$356.43	$356.43	$356.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.42 / $403.91 / $613.48	Professional		$306.42	$403.91	$613.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,435.24 / $11,500.00 / $12,000.00	Facility		$1,435.24	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $985.49 / $1,111.58 / $1,111.58	Facility	54	$985.49	$1,111.58	$1,111.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,212.96 / $2,543.67 / $2,957.78	Professional		$2,212.96	$2,543.67	$2,957.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $288.07 / $364.26 / $584.66	Facility		$288.07	$364.26	$584.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $389.47 / $474.14 / $604.53	Professional		$389.47	$474.14	$604.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $366.76 / $583.55 / $1,177.83	Professional		$366.76	$583.55	$1,177.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $288.39 / $366.99 / $605.87	Facility		$288.39	$366.99	$605.87
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $356.43 / $356.43 / $639.83	Facility	54	$356.43	$356.43	$639.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $310.70 / $424.71 / $650.58	Professional		$310.70	$424.71	$650.58
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 $253.35 / $339.65 / $526.64	Professional		$253.35	$339.65	$526.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $289.04 / $325.29 / $457.53	Professional		$289.04	$325.29	$457.53