Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $831.76 / $831.76	Facility		$812.83	$831.76	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $660.69 / $851.14	Professional		$28.84	$660.69	$851.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $61.66 / $128.82	Facility		$32.36	$61.66	$128.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $524.81 / $724.44	Professional		$29.51	$524.81	$724.44
Christus Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $912.01	Facility		$30.90	$30.90	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility		$2,630.27	$2,630.27	$2,630.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,011.87 / $7,244.36 / $7,244.36	Professional		$5,011.87	$7,244.36	$7,244.36
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $776.25 / $1,445.44	Facility		$33.88	$776.25	$1,445.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $676.08 / $1,000.00	Professional		$28.84	$676.08	$1,000.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $870.96 / $3,467.37	Professional		$33.11	$870.96	$3,467.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $776.25 / $1,479.11	Facility		$33.88	$776.25	$1,479.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $870.96 / $1,513.56	Professional		$87.10	$870.96	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $933.25	Facility		$33.88	$33.88	$933.25
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $537.03 / $1,047.13	Professional		$22.91	$537.03	$1,047.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $912.01 / $1,023.29	Professional		$28.84	$912.01	$1,023.29