Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $800.82 / $800.82 / $864.88	Facility		$800.82	$800.82	$864.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $794.56 / $864.88 / $1,601.63	Professional		$794.56	$864.88	$1,601.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,298.67 / $1,298.67 / $1,298.67	Professional		$1,298.67	$1,298.67	$1,298.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,456.92 / $5,821.21 / $8,577.84	Facility		$5,456.92	$5,821.21	$8,577.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,089.10 / $1,089.10 / $1,089.10	Professional		$1,089.10	$1,089.10	$1,089.10
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,829.11 / $1,829.11 / $1,829.11	Facility		$1,829.11	$1,829.11	$1,829.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,324.18 / $1,324.18 / $1,324.18	Facility		$1,324.18	$1,324.18	$1,324.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $966.65 / $1,324.18	Professional		$966.65	$966.65	$1,324.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,608.62 / $8,810.16 / $8,810.16	Facility		$8,608.62	$8,810.16	$8,810.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,968.65 / $10,968.65 / $12,463.80	Professional		$10,968.65	$10,968.65	$12,463.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $532.04 / $1,274.70 / $1,829.11	Facility		$532.04	$1,274.70	$1,829.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $538.04 / $1,646.20 / $1,829.11	Professional		$538.04	$1,646.20	$1,829.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $532.04 / $1,309.11 / $1,829.11	Facility		$532.04	$1,309.11	$1,829.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $966.65 / $966.65 / $1,363.91	Professional		$966.65	$966.65	$1,363.91
United Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $640.00	Facility		$640.00	$640.00	$640.00
United Facility/Professional Professional Modifier Low / Median / High Price $686.77 / $1,015.95 / $1,250.38	Professional		$686.77	$1,015.95	$1,250.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $999.58 / $1,009.19 / $1,829.11	Professional		$999.58	$1,009.19	$1,829.11