Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $329.75 / $3,570.00 / $10,836.00	Facility		$329.75	$3,570.00	$10,836.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $102.46 / $120.12 / $159.88	Facility	52	$102.46	$120.12	$159.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $219.12 / $362.06 / $1,879.10	Facility		$219.12	$362.06	$1,879.10
Christus Facility/Professional Facility Modifier Low / Median / High Price $191.66 / $191.66 / $191.66	Facility		$191.66	$191.66	$191.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $983.16	Facility		$55.00	$55.00	$983.16
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $377.21 / $764.18 / $786.53	Facility	52	$377.21	$764.18	$786.53
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $294.69 / $597.02 / $614.48	Facility	62	$294.69	$597.02	$614.48
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $47.15 / $95.52 / $98.32	Facility	AS	$47.15	$95.52	$98.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $200.02 / $259.45 / $476.75	Facility		$200.02	$259.45	$476.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $200.02 / $259.81 / $538.03	Facility		$200.02	$259.81	$538.03
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $316.18 / $316.18 / $316.18	Facility	62	$316.18	$316.18	$316.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $80.94 / $80.94 / $80.94	Facility	80	$80.94	$80.94	$80.94
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $68.80 / $68.80 / $68.80	Facility	AS	$68.80	$68.80	$68.80
United Facility/Professional Facility Modifier Low / Median / High Price $385.00 / $2,064.00 / $8,759.00	Facility		$385.00	$2,064.00	$8,759.00