Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $3,715.35 / $12,022.64	Facility		$977.24	$3,715.35	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $977.24 / $1,548.82	Professional		$758.58	$977.24	$1,548.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $870.96 / $1,096.48	Professional		$831.76	$870.96	$1,096.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $776.25 / $3,090.30	Facility		$467.74	$776.25	$3,090.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $933.25 / $1,348.96	Professional		$741.31	$933.25	$1,348.96
Christus Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $912.01	Facility		$676.08	$676.08	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $630.96	Facility		$602.56	$602.56	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,047.13 / $1,659.59	Professional		$776.25	$1,047.13	$1,659.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $6,456.54	Facility		$54.95	$56.23	$6,456.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,918.31 / $7,244.36 / $7,244.36	Professional		$6,918.31	$7,244.36	$7,244.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,047.13 / $3,548.13	Facility		$776.25	$1,047.13	$3,548.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,023.29 / $1,621.81	Professional		$776.25	$1,023.29	$1,621.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $251.19 / $1,819.70	Professional		$32.36	$251.19	$1,819.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,258.93 / $1,862.09	Professional		$724.44	$1,258.93	$1,862.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,047.13 / $1,698.24	Facility		$776.25	$1,047.13	$1,698.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,047.13 / $1,659.59	Professional		$776.25	$1,047.13	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $3,981.07 / $8,709.64	Facility		$1,258.93	$3,981.07	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $851.14 / $1,230.27	Professional		$630.96	$851.14	$1,230.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $891.25 / $891.25	Professional		$851.14	$891.25	$891.25