Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $616.60 / $1,548.82	Facility		$218.78	$616.60	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $398.11	Professional		$199.53	$263.03	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $1,023.29 / $1,698.24	Facility		$389.05	$1,023.29	$1,698.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $181.97 / $446.68	Professional		$5.01	$181.97	$446.68
Christus Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $323.59 / $331.13	Facility		$323.59	$323.59	$331.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $691.83 / $1,445.44	Facility		$229.09	$691.83	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $208.93 / $562.34	Professional		$151.36	$208.93	$562.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility		$1,548.82	$1,548.82	$1,548.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,454.71 / $2,454.71	Professional		$1,659.59	$2,454.71	$2,454.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $331.13 / $741.31	Facility		$239.88	$331.13	$741.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $257.04 / $407.38	Professional		$6.03	$257.04	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $331.13	Professional		$275.42	$275.42	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $354.81 / $707.95	Professional		$331.13	$354.81	$707.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $380.19 / $1,202.26	Facility		$234.42	$380.19	$1,202.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $223.87 / $512.86	Professional		$147.91	$223.87	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $138.04 / $331.13	Facility		$117.49	$138.04	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $229.09	Professional		$138.04	$138.04	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $275.42 / $331.13	Professional		$128.82	$275.42	$331.13