Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $2,290.87 / $6,918.31	Facility		$575.44	$2,290.87	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,000.00 / $2,089.30 / $5,888.44	Facility	50	$1,000.00	$2,089.30	$5,888.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $190.55 / $346.74	Professional		$77.62	$190.55	$346.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $257.04 / $1,096.48	Professional	50	$141.25	$257.04	$1,096.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $309.03	Professional		$77.62	$128.82	$309.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $173.78 / $512.86	Professional	50	$173.78	$173.78	$512.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,258.93 / $2,570.40	Facility		$691.83	$1,258.93	$2,570.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $162.18 / $281.84	Professional		$69.18	$162.18	$281.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $524.81 / $524.81	Facility		$75.86	$524.81	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $181.97 / $371.54	Professional		$91.20	$181.97	$371.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $19,498.45 / $19,498.45	Facility		$2,691.53	$19,498.45	$19,498.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $239.88 / $2,187.76	Facility		$83.18	$239.88	$2,187.76
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,348.96 / $2,089.30 / $5,888.44	Facility	50	$1,348.96	$2,089.30	$5,888.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $190.55 / $426.58	Professional		$79.43	$190.55	$426.58
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $257.04 / $1,096.48	Professional	50	$141.25	$257.04	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $194.98	Professional		$32.36	$33.11	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $891.25	Professional		$204.17	$288.40	$891.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $208.93 / $380.19	Facility		$81.28	$208.93	$380.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $173.78 / $380.19	Professional		$89.13	$173.78	$380.19
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 $70.79 / $154.88 / $288.40	Professional		$70.79	$154.88	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $239.88 / $239.88	Professional		$229.09	$239.88	$239.88