Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.89 / $90.63 / $92.37	Facility		$88.89	$90.63	$92.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.57 / $92.37 / $149.88	Professional		$86.57	$92.37	$149.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $199.05 / $199.05 / $199.05	Facility		$199.05	$199.05	$199.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $111.95 / $111.95	Facility		$111.95	$111.95	$111.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $81.72 / $111.95	Professional		$81.72	$81.72	$111.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $949.34 / $1,134.68 / $1,134.68	Facility		$949.34	$1,134.68	$1,134.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,146.61 / $1,146.61 / $1,379.48	Professional		$1,146.61	$1,146.61	$1,379.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $137.72 / $199.05	Facility		$57.70	$137.72	$199.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.70 / $179.15 / $203.50	Professional		$57.70	$179.15	$203.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $132.99 / $199.05	Facility		$57.70	$132.99	$199.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $81.72 / $115.31	Professional		$81.72	$81.72	$115.31
United Facility/Professional Professional Modifier Low / Median / High Price $74.48 / $106.31 / $128.22	Professional		$74.48	$106.31	$128.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.33 / $109.12 / $199.05	Professional		$107.33	$109.12	$199.05