Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.62 / $188.52 / $1,346.00	Facility		$148.62	$188.52	$1,346.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.34 / $177.79 / $244.02	Professional		$115.34	$177.79	$244.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $143.38 / $143.38 / $143.38	Professional		$143.38	$143.38	$143.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $296.08 / $696.02 / $1,285.75	Facility		$296.08	$696.02	$1,285.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $137.58 / $343.94	Professional		$137.58	$137.58	$343.94
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $80.00	Facility		$80.00	$80.00	$80.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $230.50 / $268.01 / $359.38	Facility		$230.50	$268.01	$359.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.66 / $225.23 / $363.94	Professional		$160.66	$225.23	$363.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $436.56 / $873.48 / $999.31	Facility		$436.56	$873.48	$999.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,125.58 / $1,167.66 / $1,760.18	Professional		$1,125.58	$1,167.66	$1,760.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.48 / $174.91 / $272.30	Facility		$123.48	$174.91	$272.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $129.56 / $129.56 / $208.52	Professional		$129.56	$129.56	$208.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $318.92 / $380.24 / $534.49	Professional		$318.92	$380.24	$534.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $126.68 / $180.69 / $303.91	Facility		$126.68	$180.69	$303.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $174.71 / $237.10 / $389.74	Professional		$174.71	$237.10	$389.74
United Facility/Professional Professional Modifier Low / Median / High Price $100.18 / $179.63 / $345.69	Professional		$100.18	$179.63	$345.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.56 / $161.94 / $546.97	Professional		$129.56	$161.94	$546.97