Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $481.65 / $2,550.00 / $7,542.00	Facility		$481.65	$2,550.00	$7,542.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,033.50 / $4,033.50 / $4,033.50	Facility	50	$4,033.50	$4,033.50	$4,033.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.99 / $273.63 / $505.58	Professional		$159.99	$273.63	$505.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.51 / $170.51 / $301.02	Professional		$170.51	$170.51	$301.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,666.44 / $3,018.91 / $5,844.30	Facility		$1,666.44	$3,018.91	$5,844.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.46 / $297.39 / $467.88	Professional		$166.46	$297.39	$467.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $153.44 / $2,428.87 / $2,428.87	Facility		$153.44	$2,428.87	$2,428.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,263.04 / $1,263.04 / $1,304.32	Facility		$1,263.04	$1,263.04	$1,304.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.79 / $318.25 / $506.91	Professional		$184.79	$318.25	$506.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,247.16 / $16,394.00 / $16,394.00	Facility		$1,247.16	$16,394.00	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,326.24 / $2,446.88 / $2,709.00	Professional		$1,326.24	$2,446.88	$2,709.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $177.18 / $316.82 / $513.37	Facility		$177.18	$316.82	$513.37
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $193.57 / $345.49 / $533.94	Professional		$193.57	$345.49	$533.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.70 / $307.05 / $383.63	Professional		$168.70	$307.05	$383.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $177.18 / $318.20 / $546.66	Facility		$177.18	$318.20	$546.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $188.70 / $327.83 / $545.35	Professional		$188.70	$327.83	$545.35
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,264.00 / $7,600.00	Facility		$1,120.00	$3,264.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $248.75 / $331.66 / $479.05	Professional		$248.75	$331.66	$479.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $268.06 / $301.02 / $426.38	Professional		$268.06	$301.02	$426.38