Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $3,715.35 / $12,022.64	Facility		$120.23	$3,715.35	$12,022.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $660.69 / $660.69 / $2,454.71	Facility	50	$660.69	$660.69	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $177.83	Professional		$79.43	$112.20	$177.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $173.78 / $281.84	Professional	50	$147.91	$173.78	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $117.49	Professional		$91.20	$91.20	$117.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $575.44 / $1,230.27	Facility		$234.42	$575.44	$1,230.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $141.25	Professional		$72.44	$91.20	$141.25
Christus Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $95.50	Facility		$69.18	$69.18	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $194.98	Professional		$83.18	$112.20	$194.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $1,288.25	Facility		$54.95	$56.23	$1,288.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $117.49 / $3,548.13	Facility		$74.13	$117.49	$3,548.13
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $660.69 / $660.69 / $2,454.71	Facility	50	$660.69	$660.69	$2,454.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $169.82	Professional		$79.43	$109.65	$169.82
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $109.65 / $190.55 / $660.69	Professional	50	$109.65	$190.55	$660.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $74.13 / $100.00	Professional		$32.36	$74.13	$100.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $91.20 / $109.65	Professional		$77.62	$91.20	$109.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $109.65 / $194.98	Facility		$74.13	$109.65	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $199.53	Professional		$81.28	$114.82	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,047.13 / $2,691.53	Facility		$154.88	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $151.36	Professional		$67.61	$100.00	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $95.50 / $95.50	Professional		$91.20	$95.50	$95.50