Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,050.00 / $3,682.00 / $12,826.00	Facility		$1,050.00	$3,682.00	$12,826.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,084.66 / $9,092.56 / $18,389.06	Facility		$5,084.66	$9,092.56	$18,389.06
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,212.22 / $5,655.43 / $5,655.43	Facility		$1,212.22	$5,655.43	$5,655.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,470.67 / $3,603.00 / $6,702.00	Facility		$1,470.67	$3,603.00	$6,702.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $913.41 / $913.41 / $913.41	Facility	62	$913.41	$913.41	$913.41
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $146.15 / $146.15 / $146.15	Facility	AS	$146.15	$146.15	$146.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.00 / $6,500.00 / $19,913.50	Facility		$5,897.00	$6,500.00	$19,913.50
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,751.73 / $11,796.97 / $11,796.97	Facility	62	$1,751.73	$11,796.97	$11,796.97
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $280.27 / $1,887.52 / $1,887.52	Facility	AS	$280.27	$1,887.52	$1,887.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,220.64 / $1,550.19 / $2,856.70	Facility		$1,220.64	$1,550.19	$2,856.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,224.71 / $1,564.76 / $2,924.08	Facility		$1,224.71	$1,564.76	$2,924.08
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $913.41 / $913.41 / $1,921.18	Facility	62	$913.41	$913.41	$1,921.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $491.82 / $491.82 / $491.82	Facility	80	$491.82	$491.82	$491.82
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $146.15 / $146.15 / $418.05	Facility	AS	$146.15	$146.15	$418.05
United Facility/Professional Facility Modifier Low / Median / High Price $2,605.00 / $7,333.00 / $16,000.00	Facility		$2,605.00	$7,333.00	$16,000.00