Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $74.13 / $97.72	Facility		$70.79	$74.13	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $128.82	Professional		$70.79	$85.11	$128.82
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	25	$87.10	$87.10	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $117.49	Professional		$81.28	$95.50	$117.49
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $83.18 / $93.33 / $114.82	Professional	25	$83.18	$93.33	$114.82
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 $77.62 / $87.10 / $102.33	Professional		$77.62	$87.10	$102.33
Christus Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $151.36	Professional		$85.11	$112.20	$151.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $125.89 / $616.60	Professional		$109.65	$125.89	$616.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $74.13 / $117.49	Facility		$70.79	$74.13	$117.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $141.25	Professional		$70.79	$85.11	$141.25
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 $95.50 / $114.82 / $141.25	Facility		$95.50	$114.82	$141.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $144.54	Professional		$79.43	$104.71	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $95.50 / $125.89	Professional		$69.18	$95.50	$125.89