Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $332.54 / $3,553.00 / $12,281.00	Facility		$332.54	$3,553.00	$12,281.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $112.99 / $122.23 / $181.36	Facility	52	$112.99	$122.23	$181.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $241.03 / $411.03 / $2,120.08	Facility		$241.03	$411.03	$2,120.08
Christus Facility/Professional Facility Modifier Low / Median / High Price $212.18 / $212.18 / $221.73	Facility		$212.18	$212.18	$221.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $273.83 / $2,277.00 / $4,619.00	Facility		$273.83	$2,277.00	$4,619.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $213.26 / $213.26 / $213.26	Facility	52	$213.26	$213.26	$213.26
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $26.66 / $26.66 / $26.66	Facility	AS	$26.66	$26.66	$26.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,300.00	Facility		$55.00	$55.00	$1,300.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $426.35 / $868.31 / $904.90	Facility	52	$426.35	$868.31	$904.90
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $53.29 / $108.54 / $113.11	Facility	AS	$53.29	$108.54	$113.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $229.13 / $299.13 / $537.89	Facility		$229.13	$299.13	$537.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $229.75 / $303.64 / $611.83	Facility		$229.75	$303.64	$611.83
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $213.26 / $213.26 / $213.26	Facility	52	$213.26	$213.26	$213.26
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $91.48 / $91.48 / $91.48	Facility	80	$91.48	$91.48	$91.48
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $26.66 / $77.76 / $77.76	Facility	AS	$26.66	$77.76	$77.76
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