Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $102.44 / $234.90	Facility		$84.57	$102.44	$234.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $85.37 / $102.28	Professional		$84.57	$85.37	$102.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.58 / $169.63 / $322.36	Facility		$67.58	$169.63	$322.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.60 / $82.60 / $82.60	Professional		$82.60	$82.60	$82.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $87.11 / $87.11 / $87.11	Facility		$87.11	$87.11	$87.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.78 / $84.57 / $84.57	Facility		$79.78	$84.57	$84.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $84.57	Professional		$84.57	$84.57	$84.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $112.49 / $518.54 / $588.15	Facility		$112.49	$518.54	$588.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $518.54 / $518.54 / $518.54	Professional		$518.54	$518.54	$518.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $84.53 / $84.57 / $178.06	Facility		$84.53	$84.57	$178.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $86.26 / $139.54	Professional		$84.57	$86.26	$139.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.88 / $95.82 / $155.49	Professional		$82.88	$95.82	$155.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.57 / $84.57 / $165.13	Facility		$84.57	$84.57	$165.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $84.57 / $137.05	Professional		$84.57	$84.57	$137.05
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $89.64 / $94.72	Professional		$84.57	$89.64	$94.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $92.98 / $118.40	Professional		$84.57	$92.98	$118.40