Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $194.98	Professional		$109.65	$151.36	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $120.23 / $123.03	Professional		$112.20	$120.23	$123.03
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $120.23 / $147.91 / $173.78	Professional	25	$120.23	$147.91	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $114.82 / $125.89	Professional		$102.33	$114.82	$125.89
Christus Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $144.54	Facility		$125.89	$125.89	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $281.84	Professional		$112.20	$128.82	$281.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility		$1,096.48	$1,096.48	$1,096.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $147.91 / $245.47	Facility		$117.49	$147.91	$245.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $154.88 / $194.98	Professional		$138.04	$154.88	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $147.91	Professional		$32.36	$33.11	$147.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $147.91 / $245.47	Facility		$117.49	$147.91	$245.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $269.15	Professional		$120.23	$154.88	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $275.42	Professional		$138.04	$165.96	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54