Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.29 / $351.87 / $918.62	Facility		$140.29	$351.87	$918.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $141.43 / $279.66	Professional		$113.14	$141.43	$279.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $113.14 / $113.14	Professional		$113.14	$113.14	$113.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $220.63 / $595.88 / $1,055.99	Facility		$220.63	$595.88	$1,055.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $99.94 / $188.57	Professional		$5.00	$99.94	$188.57
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $188.57 / $188.57	Facility		$80.00	$188.57	$188.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.94 / $415.83 / $998.76	Facility		$205.94	$415.83	$998.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.78 / $133.66 / $396.00	Professional		$101.78	$133.66	$396.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $437.00 / $895.71 / $895.71	Facility		$437.00	$895.71	$895.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,414.28 / $1,478.21 / $1,478.21	Professional		$1,414.28	$1,478.21	$1,478.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.77 / $247.15 / $403.54	Facility		$154.77	$247.15	$403.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $188.57 / $188.57 / $235.71	Professional		$188.57	$188.57	$235.71
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $666.73 / $862.63 / $1,390.42	Facility		$666.73	$862.63	$1,390.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $122.57 / $226.28 / $424.28	Professional		$122.57	$226.28	$424.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $154.77 / $282.86 / $688.84	Facility		$154.77	$282.86	$688.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.17 / $179.94 / $368.76	Professional		$104.17	$179.94	$368.76
United Facility/Professional Facility Modifier Low / Median / High Price $188.57 / $226.28 / $282.86	Facility		$188.57	$226.28	$282.86
United Facility/Professional Professional Modifier Low / Median / High Price $113.14 / $149.96 / $373.93	Professional		$113.14	$149.96	$373.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.68 / $101.85 / $188.57	Professional		$97.68	$101.85	$188.57