Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $409.52 / $699.77 / $915.70	Facility		$409.52	$699.77	$915.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $422.89 / $495.52	Professional		$422.89	$422.89	$495.52
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $380.19	Facility		$80.00	$80.00	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.96 / $422.89 / $422.89	Facility		$398.96	$422.89	$422.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $422.89 / $422.89	Professional		$422.89	$422.89	$422.89
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $703.90 / $2,045.05 / $2,114.44	Facility		$703.90	$2,045.05	$2,114.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,968.33 / $1,968.33 / $1,968.33	Professional		$1,968.33	$1,968.33	$1,968.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $409.52 / $422.89 / $732.06	Facility		$409.52	$422.89	$732.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $431.35 / $697.77	Professional		$422.89	$431.35	$697.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $463.83 / $855.42	Professional		$380.19	$463.83	$855.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $422.89 / $422.89 / $721.83	Facility		$422.89	$422.89	$721.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $422.89 / $509.79	Professional		$422.89	$422.89	$509.79
United Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $448.26 / $470.77	Professional		$422.89	$448.26	$470.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $399.87 / $422.89 / $592.04	Professional		$399.87	$422.89	$592.04