Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $2,454.71 / $6,918.31	Facility		$524.81	$2,454.71	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility	50	$5,248.07	$5,248.07	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $194.98 / $346.74	Professional		$125.89	$194.98	$346.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $302.00 / $812.83	Professional	50	$100.00	$302.00	$812.83
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $309.03 / $309.03 / $309.03	Professional	50	$309.03	$309.03	$309.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $446.68 / $954.99	Facility		$257.04	$446.68	$954.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $234.42	Professional		$117.49	$151.36	$234.42
Christus Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $199.53 / $199.53	Facility		$109.65	$199.53	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $204.17	Facility		$194.98	$194.98	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $354.81	Professional		$138.04	$199.53	$354.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $19,498.45 / $19,498.45	Facility		$2,570.40	$19,498.45	$19,498.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Professional		$1,479.11	$1,479.11	$1,479.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $239.88 / $3,548.13	Facility		$128.82	$239.88	$3,548.13
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility	50	$5,248.07	$5,248.07	$5,248.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $302.00	Professional		$128.82	$186.21	$302.00
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $100.00 / $295.12 / $676.08	Professional	50	$100.00	$295.12	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $120.23 / $194.98	Professional		$32.36	$120.23	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $186.21	Professional		$120.23	$154.88	$186.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $194.98 / $346.74	Facility		$128.82	$194.98	$346.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $363.08	Professional		$134.90	$199.53	$363.08
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 $117.49 / $177.83 / $295.12	Professional		$117.49	$177.83	$295.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $162.18 / $162.18	Professional		$154.88	$162.18	$162.18