Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $945.00 / $3,570.00 / $10,893.00	Facility		$945.00	$3,570.00	$10,893.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $786.47 / $846.64 / $1,248.18	Facility	52	$786.47	$846.64	$1,248.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,670.03 / $2,765.98 / $7,149.80	Facility		$1,670.03	$2,765.98	$7,149.80
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,496.14 / $1,601.29 / $1,601.29	Facility		$1,496.14	$1,601.29	$1,601.29
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 $1,471.60 / $1,471.60 / $1,471.60	Facility	52	$1,471.60	$1,471.60	$1,471.60
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $183.95 / $183.95 / $183.95	Facility	AS	$183.95	$183.95	$183.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $14,819.60	Facility		$55.00	$55.00	$14,819.60
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,903.22 / $5,994.70 / $6,344.10	Facility	52	$2,903.22	$5,994.70	$6,344.10
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $362.90 / $749.34 / $793.01	Facility	AS	$362.90	$749.34	$793.01
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,561.00 / $1,906.45 / $3,404.08	Facility		$1,561.00	$1,906.45	$3,404.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,567.82 / $1,937.50 / $3,774.95	Facility		$1,567.82	$1,937.50	$3,774.95
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,471.60 / $1,471.60 / $1,471.60	Facility	52	$1,471.60	$1,471.60	$1,471.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $632.76 / $632.76 / $632.76	Facility	80	$632.76	$632.76	$632.76
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $183.95 / $537.85 / $537.85	Facility	AS	$183.95	$537.85	$537.85
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