Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $398.11	Professional		$87.10	$87.10	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $21.38 / $89.13	Professional		$7.59	$21.38	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $208.93	Professional		$177.83	$208.93	$208.93
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $288.40 / $870.96	Professional		$107.15	$288.40	$870.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $616.60 / $616.60	Professional		$549.54	$616.60	$616.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $97.72 / $758.58	Facility		$87.10	$97.72	$758.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $398.11	Professional		$87.10	$87.10	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Professional		$363.08	$363.08	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $100.00 / $645.65	Facility		$87.10	$100.00	$645.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $107.15	Professional		$60.26	$79.43	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $380.19	Professional		$100.00	$151.36	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $85.11	Professional		$69.18	$69.18	$85.11