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 $883.99 / $947.50 / $1,398.97	Facility	52	$883.99	$947.50	$1,398.97
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,690.33 / $1,690.33 / $1,741.51	Facility		$1,690.33	$1,690.33	$1,741.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $2,094.52 / $4,619.00	Facility		$900.00	$2,094.52	$4,619.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,648.76 / $1,648.76 / $1,648.76	Facility	52	$1,648.76	$1,648.76	$1,648.76
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $206.10 / $206.10 / $206.10	Facility	AS	$206.10	$206.10	$206.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $16,659.20	Facility		$55.00	$55.00	$16,659.20
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $3,263.14 / $6,724.98 / $7,170.18	Facility	52	$3,263.14	$6,724.98	$7,170.18
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $407.89 / $840.62 / $896.27	Facility	AS	$407.89	$840.62	$896.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,732.56 / $2,099.69 / $3,829.45	Facility		$1,732.56	$2,099.69	$3,829.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,734.82 / $2,111.48 / $4,230.09	Facility		$1,734.82	$2,111.48	$4,230.09
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,648.76 / $1,648.76 / $1,648.76	Facility	52	$1,648.76	$1,648.76	$1,648.76
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $707.15 / $707.15 / $707.15	Facility	80	$707.15	$707.15	$707.15
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $206.10 / $601.08 / $601.08	Facility	AS	$206.10	$601.08	$601.08
United Facility/Professional Facility Modifier Low / Median / High Price $471.00 / $2,502.00 / $9,000.00	Facility		$471.00	$2,502.00	$9,000.00