Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $87.10 / $128.82	Facility		$52.48	$87.10	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $53.70 / $64.57	Professional		$52.48	$53.70	$64.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $102.33 / $199.53	Facility		$41.69	$102.33	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70
Christus Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $79.43	Facility		$53.70	$53.70	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $53.70 / $53.70	Facility		$51.29	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $58.88 / $95.50	Facility		$53.70	$58.88	$95.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $58.88	Professional		$52.48	$52.48	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $50.12 / $58.88	Professional		$40.74	$50.12	$58.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $72.44 / $97.72	Professional		$0.60	$72.44	$97.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $54.95 / $93.33	Facility		$53.70	$54.95	$93.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $61.66	Professional		$53.70	$53.70	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $53.70 / $53.70	Facility		$52.48	$53.70	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $57.54 / $60.26	Professional		$53.70	$57.54	$60.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $53.70 / $67.61	Professional		$48.98	$53.70	$67.61