Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $125.89 / $1,412.54	Facility		$102.33	$125.89	$1,412.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $263.03	Professional		$109.65	$144.54	$263.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $380.19 / $2,570.40	Facility		$151.36	$380.19	$2,570.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $141.25 / $181.97	Professional		$70.79	$141.25	$181.97
Christus Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $154.88	Facility		$144.54	$144.54	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $537.03 / $5,754.40	Facility		$245.47	$537.03	$5,754.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $602.56	Professional		$128.82	$208.93	$602.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,162.28	Professional		$3,162.28	$3,162.28	$3,162.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $234.42 / $707.95	Facility		$131.83	$234.42	$707.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $288.40	Professional		$112.20	$169.82	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $123.03	Professional		$32.36	$33.11	$123.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $380.19 / $1,000.00	Professional		$269.15	$380.19	$1,000.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $263.03 / $776.25	Facility		$134.90	$263.03	$776.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $489.78	Professional		$128.82	$208.93	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $5,011.87 / $6,606.93	Facility		$2,511.89	$5,011.87	$6,606.93
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $190.55 / $426.58	Professional		$141.25	$190.55	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $151.36 / $181.97	Professional		$144.54	$151.36	$181.97