Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $686.00 / $831.32 / $1,371.82	Facility		$686.00	$831.32	$1,371.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $692.77 / $823.20	Professional		$686.00	$692.77	$823.20
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $686.08	Facility		$80.00	$80.00	$686.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $647.16 / $686.00 / $686.00	Facility		$647.16	$686.00	$686.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $686.00	Professional		$686.00	$686.00	$686.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $853.76 / $3,209.15 / $3,430.00	Facility		$853.76	$3,209.15	$3,430.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,835.75 / $2,835.75 / $2,835.75	Professional		$2,835.75	$2,835.75	$2,835.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $685.91 / $686.00 / $1,444.27	Facility		$685.91	$686.00	$1,444.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $699.72 / $1,131.90	Professional		$686.00	$699.72	$1,131.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $672.28 / $754.69 / $1,200.50	Professional		$672.28	$754.69	$1,200.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $686.00 / $686.00 / $1,275.96	Facility		$686.00	$686.00	$1,275.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $686.00 / $802.69	Professional		$686.00	$686.00	$802.69
United Facility/Professional Facility Modifier Low / Median / High Price $686.00 / $686.00 / $686.00	Facility		$686.00	$686.00	$686.00
United Facility/Professional Professional Modifier Low / Median / High Price $686.00 / $727.16 / $763.66	Professional		$686.00	$727.16	$763.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $642.29 / $686.00 / $960.40	Professional		$642.29	$686.00	$960.40