Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $112.20 / $138.04	Professional		$91.20	$112.20	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $144.54	Professional		$102.33	$125.89	$144.54
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $107.15 / $125.89 / $158.49	Professional	25	$107.15	$125.89	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $114.82	Professional		$91.20	$102.33	$114.82
Christus Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $128.82	Facility		$123.03	$123.03	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $117.49 / $208.93	Professional		$102.33	$117.49	$208.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $125.89 / $173.78	Facility		$81.28	$125.89	$173.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $141.25	Professional		$100.00	$117.49	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $120.23 / $173.78	Facility		$81.28	$120.23	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $190.55	Professional		$107.15	$123.03	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $194.98	Professional		$97.72	$117.49	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82