Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $969.00 / $3,570.00 / $10,836.00	Facility		$969.00	$3,570.00	$10,836.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $579.17 / $624.66 / $928.11	Facility	52	$579.17	$624.66	$928.11
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $231.67 / $249.87 / $371.24	Facility	53	$231.67	$249.87	$371.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,112.44 / $1,463.92 / $5,155.53	Facility		$1,112.44	$1,463.92	$5,155.53
Christus Facility/Professional Facility Modifier Low / Median / High Price $585.27 / $585.27 / $1,110.59	Facility		$585.27	$585.27	$1,110.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $2,024.00 / $4,619.00	Facility		$900.00	$2,024.00	$4,619.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $1,091.32 / $1,091.32	Facility	52	$1,091.32	$1,091.32	$1,091.32
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $272.83 / $272.83	Facility	53	$272.83	$272.83	$272.83
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $136.41 / $136.41	Facility	AS	$136.41	$136.41	$136.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $11,004.64	Facility		$55.00	$55.00	$11,004.64
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,157.09 / $4,456.67 / $4,701.51	Facility	52	$2,157.09	$4,456.67	$4,701.51
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $539.27 / $1,114.17 / $1,175.38	Facility	53	$539.27	$1,114.17	$1,175.38
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $269.64 / $557.08 / $587.69	Facility	AS	$269.64	$557.08	$587.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,150.86 / $1,408.20 / $2,494.04	Facility		$1,150.86	$1,408.20	$2,494.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,151.48 / $1,419.28 / $2,774.71	Facility		$1,151.48	$1,419.28	$2,774.71
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $1,091.32 / $1,091.32	Facility	52	$1,091.32	$1,091.32	$1,091.32
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $272.83 / $272.83	Facility	53	$272.83	$272.83	$272.83
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $467.15 / $467.15 / $467.15	Facility	80	$467.15	$467.15	$467.15
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $397.08 / $397.08	Facility	AS	$136.41	$397.08	$397.08
United Facility/Professional Facility Modifier Low / Median / High Price $385.00 / $1,970.00 / $8,583.00	Facility		$385.00	$1,970.00	$8,583.00