Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $67.61	Facility		$64.57	$64.57	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $72.44 / $109.65	Professional		$61.66	$72.44	$109.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $87.10	Professional		$70.79	$70.79	$87.10
Christus Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $81.28	Professional		$60.26	$60.26	$81.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,071.52 / $1,071.52	Professional		$741.31	$1,071.52	$1,071.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $120.23 / $190.55	Facility		$64.57	$120.23	$190.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $72.44 / $141.25	Professional		$64.57	$72.44	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $95.50	Professional		$93.33	$93.33	$95.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $112.20 / $199.53	Facility		$64.57	$112.20	$199.53
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $81.28	Professional		$60.26	$60.26	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $66.07 / $151.36	Facility		$40.74	$66.07	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $79.43 / $93.33	Professional		$54.95	$79.43	$93.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36