Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $102.33	Facility		$100.00	$100.00	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $107.15 / $173.78	Professional		$93.33	$107.15	$173.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,548.13 / $4,265.80	Facility		$3,162.28	$3,548.13	$4,265.80
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $229.09 / $229.09	Facility		$79.43	$229.09	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $134.90	Professional		$100.00	$100.00	$134.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Professional		$2,884.03	$2,884.03	$2,884.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $181.97 / $295.12	Facility		$97.72	$181.97	$295.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $234.42	Professional		$97.72	$114.82	$234.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $128.82	Professional		$125.89	$125.89	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $173.78 / $316.23	Facility		$97.72	$173.78	$316.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $134.90	Professional		$100.00	$100.00	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $107.15 / $251.19	Facility		$67.61	$107.15	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $154.88	Professional		$91.20	$131.83	$154.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09