Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.98 / $1,900.00 / $6,691.00	Facility		$310.98	$1,900.00	$6,691.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $195.71 / $222.88 / $371.66	Facility	54	$195.71	$222.88	$371.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.35 / $314.70 / $538.09	Professional		$266.35	$314.70	$538.09
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 $194.08 / $347.18 / $790.83	Facility		$194.08	$347.18	$790.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.72 / $355.03 / $504.00	Professional		$288.72	$355.03	$504.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $307.47 / $307.93	Facility		$80.00	$307.47	$307.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.76 / $528.76 / $528.76	Facility		$528.76	$528.76	$528.76
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $370.13 / $370.13 / $370.13	Facility	54	$370.13	$370.13	$370.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.35 / $408.20 / $626.29	Professional		$311.35	$408.20	$626.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,482.40 / $11,500.00 / $12,000.00	Facility		$1,482.40	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,021.52 / $1,149.69 / $1,149.69	Facility	54	$1,021.52	$1,149.69	$1,149.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,295.52 / $2,416.23 / $2,808.38	Professional		$2,295.52	$2,416.23	$2,808.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $297.17 / $372.14 / $581.46	Facility		$297.17	$372.14	$581.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $389.78 / $467.73 / $579.99	Professional		$389.78	$467.73	$579.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $361.94 / $567.84 / $1,189.71	Professional		$361.94	$567.84	$1,189.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $297.70 / $374.64 / $618.50	Facility		$297.70	$374.64	$618.50
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $370.13 / $370.13 / $613.50	Facility	54	$370.13	$370.13	$613.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $421.36 / $647.49	Professional		$316.31	$421.36	$647.49
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 $246.59 / $328.78 / $512.72	Professional		$246.59	$328.78	$512.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $274.69 / $309.81 / $434.54	Professional		$274.69	$309.81	$434.54