Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $691.83 / $794.33	Facility		$389.05	$691.83	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $398.11 / $489.78	Professional		$389.05	$398.11	$489.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $691.83 / $1,288.25	Facility		$288.40	$691.83	$1,288.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $389.05 / $389.05	Facility		$79.43	$389.05	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $389.05 / $389.05	Facility		$371.54	$389.05	$389.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility		$1,949.84	$1,949.84	$1,949.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,309.57 / $6,309.57 / $6,309.57	Professional		$6,309.57	$6,309.57	$6,309.57
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $398.11 / $645.65	Facility		$389.05	$398.11	$645.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $426.58	Professional		$389.05	$389.05	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $446.68	Professional		$302.00	$363.08	$446.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $354.81 / $724.44	Professional		$30.20	$354.81	$724.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $398.11 / $645.65	Facility		$288.40	$398.11	$645.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $426.58	Professional		$389.05	$389.05	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $416.87 / $436.52	Professional		$389.05	$416.87	$436.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $389.05 / $489.78	Professional		$371.54	$389.05	$489.78