Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $488.00 / $2,131.00 / $7,513.00	Facility		$488.00	$2,131.00	$7,513.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.51 / $351.90 / $598.35	Professional		$308.51	$351.90	$598.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,530.22 / $2,699.38 / $5,381.57	Facility		$1,530.22	$2,699.38	$5,381.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.44 / $401.28 / $581.57	Professional		$330.44	$401.28	$581.57
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $362.16 / $367.50	Facility		$80.00	$362.16	$367.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.06 / $424.06 / $424.06	Facility		$424.06	$424.06	$424.06
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $263.31 / $263.31 / $263.31	Facility	62	$263.31	$263.31	$263.31
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $42.13 / $42.13 / $42.13	Facility	AS	$42.13	$42.13	$42.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $367.01 / $489.90 / $739.94	Professional		$367.01	$489.90	$739.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,751.45 / $11,500.00 / $12,000.00	Facility		$1,751.45	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $530.13 / $3,107.91 / $3,107.91	Facility	62	$530.13	$3,107.91	$3,107.91
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $84.82 / $497.27 / $497.27	Facility	AS	$84.82	$497.27	$497.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,131.06 / $4,131.06 / $4,131.06	Professional		$4,131.06	$4,131.06	$4,131.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $333.48 / $419.87 / $744.00	Facility		$333.48	$419.87	$744.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $432.54 / $553.13 / $685.88	Professional		$432.54	$553.13	$685.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $367.21 / $632.77 / $1,397.61	Professional		$367.21	$632.77	$1,397.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $333.95 / $419.87 / $781.64	Facility		$333.95	$419.87	$781.64
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $263.31 / $263.31 / $537.01	Facility	62	$263.31	$263.31	$537.01
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $137.47 / $137.47 / $137.47	Facility	80	$137.47	$137.47	$137.47
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $42.13 / $42.13 / $116.85	Facility	AS	$42.13	$42.13	$116.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $369.12 / $507.47 / $757.13	Professional		$369.12	$507.47	$757.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,326.00 / $7,600.00	Facility		$1,154.00	$3,326.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.14 / $380.24 / $608.16	Professional		$280.14	$380.24	$608.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $314.72 / $356.66 / $496.07	Professional		$314.72	$356.66	$496.07