Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $3,715.35 / $12,589.25	Facility		$870.96	$3,715.35	$12,589.25
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,949.84 / $3,162.28 / $3,801.89	Facility	50	$1,949.84	$3,162.28	$3,801.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $645.65 / $1,122.02	Professional		$467.74	$645.65	$1,122.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $724.44 / $1,949.84 / $3,388.44	Professional	50	$724.44	$1,949.84	$3,388.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $676.08 / $676.08 / $707.95	Professional	50	$676.08	$676.08	$707.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,162.28 / $6,165.95	Facility		$1,737.80	$3,162.28	$6,165.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $575.44 / $912.01	Professional		$446.68	$575.44	$912.01
Christus Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,621.81 / $1,621.81	Facility		$398.11	$1,621.81	$1,621.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,318.26	Facility		$1,258.93	$1,258.93	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $1,023.29	Professional		$489.78	$660.69	$1,023.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $33,884.42 / $33,884.42	Facility		$5,754.40	$33,884.42	$33,884.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,585.78 / $7,585.78 / $7,585.78	Professional		$7,585.78	$7,585.78	$7,585.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $794.33 / $4,466.84	Facility		$478.63	$794.33	$4,466.84
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,949.84 / $2,187.76 / $3,801.89	Facility	50	$1,949.84	$2,187.76	$3,801.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $660.69 / $1,096.48	Professional		$478.63	$660.69	$1,096.48
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $645.65 / $2,089.30 / $3,388.44	Professional	50	$645.65	$2,089.30	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $380.19 / $575.44	Professional		$32.36	$380.19	$575.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $588.84 / $707.95	Professional		$436.52	$588.84	$707.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $707.95 / $1,174.90	Facility		$478.63	$707.95	$1,174.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $676.08 / $1,023.29	Professional		$478.63	$676.08	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $4,073.80 / $8,709.64	Facility		$1,258.93	$4,073.80	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $549.54 / $831.76	Professional		$416.87	$549.54	$831.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $616.60 / $616.60	Professional		$588.84	$616.60	$616.60