Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.40 / $99.40 / $249.20	Facility		$99.40	$99.40	$249.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.49 / $99.40 / $122.51	Professional		$84.49	$99.40	$122.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $278.41 / $555.50	Facility		$110.00	$278.41	$555.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.85 / $89.85 / $89.85	Professional		$89.85	$89.85	$89.85
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $89.97 / $89.97 / $115.00	Facility		$89.97	$89.97	$115.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.77 / $92.77 / $92.77	Facility		$92.77	$92.77	$92.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.77 / $92.77 / $92.77	Professional		$92.77	$92.77	$92.77
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $179.17 / $275.97 / $372.75	Facility		$179.17	$275.97	$372.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $99.40 / $108.60 / $142.13	Facility		$99.40	$108.60	$142.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.70 / $91.70 / $91.70	Professional		$91.70	$91.70	$91.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.89 / $92.77 / $142.13	Facility		$91.89	$92.77	$142.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.77 / $92.77 / $131.03	Professional		$92.77	$92.77	$131.03
United Facility/Professional Professional Modifier Low / Median / High Price $78.69 / $97.74 / $130.53	Professional		$78.69	$97.74	$130.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.83 / $82.83 / $111.82	Professional		$82.83	$82.83	$111.82