Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $823.26 / $839.40 / $855.54	Facility		$823.26	$839.40	$855.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $774.83 / $855.54 / $1,367.47	Professional		$774.83	$855.54	$1,367.47
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,843.50 / $1,843.50 / $1,843.50	Facility		$1,843.50	$1,843.50	$1,843.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,149.77 / $1,149.77 / $1,149.77	Facility		$1,149.77	$1,149.77	$1,149.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $839.33 / $839.33 / $1,149.77	Professional		$839.33	$839.33	$1,149.77
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,164.45 / $7,860.20 / $9,402.01	Facility		$4,164.45	$7,860.20	$9,402.01
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $13,164.93 / $13,480.88 / $13,480.88	Professional		$13,164.93	$13,480.88	$13,480.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $478.13 / $1,275.50 / $1,843.50	Facility		$478.13	$1,275.50	$1,843.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $478.13 / $1,561.69 / $1,843.50	Professional		$478.13	$1,561.69	$1,843.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,120.03 / $2,162.42 / $3,018.03	Professional		$2,120.03	$2,162.42	$3,018.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $478.13 / $1,231.76 / $1,843.50	Facility		$478.13	$1,231.76	$1,843.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $839.33 / $839.33 / $1,184.26	Professional		$839.33	$839.33	$1,184.26
United Facility/Professional Professional Modifier Low / Median / High Price $617.17 / $892.51 / $1,062.50	Professional		$617.17	$892.51	$1,062.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $889.39 / $904.15 / $1,843.50	Professional		$889.39	$904.15	$1,843.50