Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $1,995.26 / $6,918.31	Facility		$457.09	$1,995.26	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $338.84 / $467.74 / $660.69	Facility	50	$338.84	$467.74	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $95.50 / $245.47	Professional		$56.23	$95.50	$245.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $229.09 / $371.54 / $416.87	Professional	50	$229.09	$371.54	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $102.33 / $467.74	Professional		$56.23	$102.33	$467.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $107.15 / $107.15 / $138.04	Professional	50	$107.15	$107.15	$138.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $977.24 / $2,041.74	Facility		$537.03	$977.24	$2,041.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $87.10 / $123.03	Professional		$53.70	$87.10	$123.03
Christus Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $724.44 / $724.44	Facility		$51.29	$724.44	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $117.49 / $223.87	Professional		$67.61	$117.49	$223.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $19,498.45 / $19,498.45	Facility		$2,089.30	$19,498.45	$19,498.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $131.83 / $1,995.26	Facility		$57.54	$131.83	$1,995.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $194.98	Professional		$57.54	$97.72	$194.98
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	50	$229.09	$229.09	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $83.18	Professional		$32.36	$33.11	$83.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $194.98 / $398.11	Professional		$154.88	$194.98	$398.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $114.82 / $245.47	Facility		$57.54	$114.82	$245.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $117.49 / $218.78	Professional		$64.57	$117.49	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,698.24 / $4,168.69	Facility		$436.52	$1,698.24	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $93.33 / $181.97	Professional		$56.23	$93.33	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $107.15	Professional		$102.33	$107.15	$107.15