Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $134.90 / $177.83	Facility		$128.82	$134.90	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $208.93	Professional		$125.89	$147.91	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $194.98	Professional		$141.25	$169.82	$194.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $158.49 / $181.97	Professional	25	$138.04	$158.49	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,548.13 / $4,265.80	Facility		$3,162.28	$3,548.13	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $147.91 / $173.78	Professional		$131.83	$147.91	$173.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $204.17 / $263.03	Professional		$147.91	$204.17	$263.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $134.90 / $229.09	Facility		$128.82	$134.90	$229.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $263.03	Professional		$128.82	$151.36	$263.03
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	25	$186.21	$186.21	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $173.78	Professional		$32.36	$33.11	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $190.55 / $257.04	Facility		$158.49	$190.55	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $251.19	Professional		$141.25	$186.21	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $229.09	Professional		$128.82	$169.82	$229.09