Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $537.03	Facility		$501.19	$501.19	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $616.60 / $1,000.00	Professional		$489.78	$616.60	$1,000.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $870.96 / $1,047.13	Professional		$645.65	$870.96	$1,047.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $891.25	Professional		$660.69	$660.69	$891.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,754.40 / $5,754.40 / $5,754.40	Facility		$5,754.40	$5,754.40	$5,754.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $9,332.54 / $9,332.54	Professional		$6,165.95	$9,332.54	$9,332.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,000.00 / $1,548.82	Facility		$501.19	$1,000.00	$1,548.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $660.69 / $1,230.27	Professional		$501.19	$660.69	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $676.08	Professional		$660.69	$660.69	$676.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $912.01 / $1,621.81	Facility		$501.19	$912.01	$1,621.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $891.25	Professional		$660.69	$660.69	$891.25
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $831.76 / $1,288.25	Facility		$416.87	$831.76	$1,288.25
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $691.83 / $851.14	Professional		$467.74	$691.83	$851.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Professional		$1,174.90	$1,174.90	$1,174.90