Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $3,570.00 / $12,941.00	Facility		$921.00	$3,570.00	$12,941.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $366.64 / $394.16 / $585.80	Facility	52	$366.64	$394.16	$585.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $820.48 / $894.52 / $2,941.20	Facility		$820.48	$894.52	$2,941.20
Christus Facility/Professional Facility Modifier Low / Median / High Price $711.38 / $711.38 / $734.42	Facility		$711.38	$711.38	$734.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.09 / $2,024.00 / $4,619.00	Facility		$875.09	$2,024.00	$4,619.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $688.97 / $688.97 / $688.97	Facility	52	$688.97	$688.97	$688.97
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $86.12 / $86.12 / $86.12	Facility	AS	$86.12	$86.12	$86.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $2,000.00 / $6,097.28	Facility		$55.00	$2,000.00	$6,097.28
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,361.30 / $2,816.91 / $2,997.29	Facility	52	$1,361.30	$2,816.91	$2,997.29
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $170.16 / $352.11 / $374.66	Facility	AS	$170.16	$352.11	$374.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $733.54 / $923.59 / $1,576.33	Facility		$733.54	$923.59	$1,576.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $735.41 / $935.98 / $1,745.53	Facility		$735.41	$935.98	$1,745.53
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $688.97 / $688.97 / $688.97	Facility	52	$688.97	$688.97	$688.97
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $294.48 / $294.48 / $294.48	Facility	80	$294.48	$294.48	$294.48
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $86.12 / $250.31 / $250.31	Facility	AS	$86.12	$250.31	$250.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,200.00 / $10,600.00	Facility		$1,634.00	$4,200.00	$10,600.00