Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,862.09 / $3,388.44	Facility		$812.83	$1,862.09	$3,388.44
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 Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $1,621.81	Facility		$794.33	$794.33	$1,621.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Professional		$794.33	$794.33	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $1,659.59	Facility		$794.33	$794.33	$1,659.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $1,230.27 / $1,621.81	Facility		$630.96	$1,230.27	$1,621.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $15.85 / $19.95	Professional		$15.85	$15.85	$19.95