Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $155.12 / $222.02	Facility		$100.09	$155.12	$222.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $101.09 / $120.10	Professional		$100.09	$101.09	$120.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.50 / $208.07 / $415.16	Facility		$85.50	$208.07	$415.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.22 / $104.22 / $104.22	Professional		$104.22	$104.22	$104.22
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $104.99	Facility		$80.00	$80.00	$104.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.42 / $100.09 / $100.09	Facility		$94.42	$100.09	$100.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $100.09	Professional		$100.09	$100.09	$100.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $129.21 / $485.70 / $500.45	Facility		$129.21	$485.70	$500.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $428.03 / $428.03 / $428.03	Professional		$428.03	$428.03	$428.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $100.30 / $175.07	Facility		$100.09	$100.30	$175.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $102.09 / $165.15	Professional		$100.09	$102.09	$165.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $115.10 / $197.10	Professional		$100.09	$115.10	$197.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.09 / $100.09 / $179.55	Facility		$100.09	$100.09	$179.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $121.19	Professional		$100.09	$100.09	$121.19
United Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $106.10 / $111.42	Professional		$100.09	$106.10	$111.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.95 / $100.09 / $140.13	Professional		$96.95	$100.09	$140.13