Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $91.20	Facility		$89.13	$89.13	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $89.13 / $91.20	Professional		$79.43	$89.13	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $61.66 / $69.18	Professional		$52.48	$61.66	$69.18
Christus Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $19.05 / $19.05	Facility		$19.05	$19.05	$19.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $100.00	Professional		$79.43	$79.43	$100.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $91.20 / $128.82	Facility		$63.10	$91.20	$128.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $89.13 / $89.13	Professional		$85.11	$89.13	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $91.20 / $128.82	Facility		$89.13	$91.20	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Professional		$16.98	$16.98	$16.98