Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $298.56 / $298.56 / $322.44	Facility		$298.56	$298.56	$322.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.16 / $317.42 / $597.12	Professional		$250.16	$317.42	$597.12
Christus Facility/Professional Facility Modifier Low / Median / High Price $681.93 / $681.93 / $681.93	Facility		$681.93	$681.93	$681.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $364.44 / $364.44 / $364.44	Facility		$364.44	$364.44	$364.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.04 / $266.04 / $364.44	Professional		$266.04	$266.04	$364.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,240.97 / $2,756.24 / $3,275.46	Facility		$1,240.97	$2,756.24	$3,275.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,923.06 / $4,017.20 / $4,433.25	Professional		$3,923.06	$4,017.20	$4,433.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $166.57 / $475.24 / $681.93	Facility		$166.57	$475.24	$681.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $168.45 / $613.74 / $681.93	Professional		$168.45	$613.74	$681.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $166.57 / $455.65 / $681.93	Facility		$166.57	$455.65	$681.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $266.04 / $266.04 / $388.52	Professional		$266.04	$266.04	$388.52
United Facility/Professional Professional Modifier Low / Median / High Price $215.02 / $318.07 / $397.59	Professional		$215.02	$318.07	$397.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $312.95 / $315.95 / $681.93	Professional		$312.95	$315.95	$681.93