Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $91.20	Facility		$87.10	$87.10	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $154.88	Professional		$83.18	$97.72	$154.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $204.17 / $204.17	Facility		$79.43	$204.17	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $112.20	Professional		$81.28	$81.28	$112.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,380.38 / $1,380.38	Professional		$1,148.15	$1,380.38	$1,380.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $162.18 / $257.04	Facility		$87.10	$162.18	$257.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $208.93	Professional		$85.11	$107.15	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $114.82	Professional		$112.20	$112.20	$114.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $151.36 / $269.15	Facility		$87.10	$151.36	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $112.20	Professional		$81.28	$81.28	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $89.13 / $208.93	Facility		$56.23	$89.13	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $128.82	Professional		$74.13	$107.15	$128.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17