Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $3,630.78 / $12,022.64	Facility		$870.96	$3,630.78	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $338.84	Professional		$169.82	$204.17	$338.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $165.96 / $169.82	Facility		$79.43	$165.96	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $407.38	Professional		$186.21	$269.15	$407.38
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $45,708.82 / $45,708.82	Facility		$2,511.89	$45,708.82	$45,708.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,659.59 / $1,659.59	Professional		$1,380.38	$1,659.59	$1,659.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $288.40 / $3,890.45	Facility		$177.83	$288.40	$3,890.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $302.00	Professional		$169.82	$229.09	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $32.36 / $162.18	Professional		$25.12	$32.36	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $363.08	Professional		$245.47	$245.47	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $245.47 / $436.52	Facility		$177.83	$245.47	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $407.38	Professional		$181.97	$269.15	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,047.13 / $2,691.53	Facility		$158.49	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $323.59	Professional		$154.88	$208.93	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $177.83	Professional		$162.18	$177.83	$177.83