Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $923.00 / $4,499.00 / $17,640.00	Facility		$923.00	$4,499.00	$17,640.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $383.08 / $437.77 / $578.29	Facility	52	$383.08	$437.77	$578.29
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $153.22 / $175.11 / $231.32	Facility	53	$153.22	$175.11	$231.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.10 / $1,335.11 / $6,929.30	Facility		$812.10	$1,335.11	$6,929.30
Christus Facility/Professional Facility Modifier Low / Median / High Price $603.44 / $789.78 / $789.78	Facility		$603.44	$789.78	$789.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $9,409.18	Facility		$55.00	$55.00	$9,409.18
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,360.78 / $2,769.66 / $2,900.39	Facility	52	$1,360.78	$2,769.66	$2,900.39
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $340.19 / $692.42 / $725.10	Facility	53	$340.19	$692.42	$725.10
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,063.10 / $2,163.80 / $2,265.92	Facility	62	$1,063.10	$2,163.80	$2,265.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $734.42 / $875.54 / $1,758.03	Facility		$734.42	$875.54	$1,758.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $734.42 / $902.84 / $1,970.20	Facility		$734.42	$902.84	$1,970.20
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $6,000.00 / $13,134.00	Facility		$2,093.00	$6,000.00	$13,134.00