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 $783.49 / $841.27 / $1,246.99	Facility	52	$783.49	$841.27	$1,246.99
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,483.47 / $2,728.00 / $2,728.00	Facility		$1,483.47	$2,728.00	$2,728.00
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 $1,468.02 / $1,468.02 / $1,468.02	Facility	52	$1,468.02	$1,468.02	$1,468.02
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $183.50 / $183.50 / $183.50	Facility	AS	$183.50	$183.50	$183.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $14,827.68	Facility		$55.00	$55.00	$14,827.68
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,924.66 / $5,982.62 / $6,344.41	Facility	52	$2,924.66	$5,982.62	$6,344.41
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $365.58 / $747.83 / $793.05	Facility	AS	$365.58	$747.83	$793.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,582.47 / $1,967.44 / $3,396.77	Facility		$1,582.47	$1,967.44	$3,396.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,582.72 / $1,996.70 / $3,757.75	Facility		$1,582.72	$1,996.70	$3,757.75
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,468.02 / $1,468.02 / $1,468.02	Facility	52	$1,468.02	$1,468.02	$1,468.02
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $628.14 / $628.14 / $628.14	Facility	80	$628.14	$628.14	$628.14
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $183.50 / $533.91 / $533.91	Facility	AS	$183.50	$533.91	$533.91
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