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 $836.68 / $900.53 / $1,333.50	Facility	52	$836.68	$900.53	$1,333.50
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,597.79 / $1,597.79 / $1,654.20	Facility		$1,597.79	$1,597.79	$1,654.20
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 $1,570.62 / $1,570.62 / $1,570.62	Facility	52	$1,570.62	$1,570.62	$1,570.62
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $196.33 / $196.33 / $196.33	Facility	AS	$196.33	$196.33	$196.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $15,834.88	Facility		$55.00	$55.00	$15,834.88
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $3,106.99 / $6,402.84 / $6,776.16	Facility	52	$3,106.99	$6,402.84	$6,776.16
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $388.37 / $800.36 / $847.02	Facility	AS	$388.37	$800.36	$847.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,583.53 / $1,948.84 / $3,611.94	Facility		$1,583.53	$1,948.84	$3,611.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,585.76 / $1,980.00 / $4,015.04	Facility		$1,585.76	$1,980.00	$4,015.04
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,570.62 / $1,570.62 / $1,570.62	Facility	52	$1,570.62	$1,570.62	$1,570.62
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $672.98 / $672.98 / $672.98	Facility	80	$672.98	$672.98	$672.98
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $196.33 / $572.03 / $572.03	Facility	AS	$196.33	$572.03	$572.03
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