Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $186.21 / $234.42	Facility		$87.10	$186.21	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $104.71	Professional		$87.10	$87.10	$104.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $169.82 / $323.59	Facility		$67.61	$169.82	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Christus Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $87.10 / $87.10	Facility		$81.28	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Professional		$512.86	$512.86	$512.86
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $95.50 / $158.49	Facility		$87.10	$95.50	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $104.71	Professional		$87.10	$87.10	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $93.33	Professional		$30.20	$30.20	$93.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $30.20 / $186.21	Professional		$0.60	$30.20	$186.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $91.20 / $158.49	Facility		$87.10	$91.20	$158.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Professional		$87.10	$87.10	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $93.33 / $97.72	Professional		$87.10	$93.33	$97.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $117.49	Professional		$87.10	$87.10	$117.49