Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $371.54 / $1,698.24	Facility		$173.78	$371.54	$1,698.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $181.97	Professional		$162.18	$173.78	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $316.23 / $4,265.80	Facility		$245.47	$316.23	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Professional		$53.70	$53.70	$53.70
Christus Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $177.83	Professional		$100.00	$147.91	$177.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $114.82	Professional		$104.71	$114.82	$114.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $380.19	Facility		$173.78	$173.78	$380.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $173.78	Professional		$162.18	$173.78	$173.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $72.44	Professional		$47.86	$63.10	$72.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $177.83 / $380.19	Facility		$173.78	$177.83	$380.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $102.33	Professional		$60.26	$79.43	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $223.87 / $295.12	Facility		$100.00	$223.87	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $125.89	Professional		$53.70	$53.70	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $131.83 / $162.18	Professional		$30.20	$131.83	$162.18