Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.55 / $71.55 / $72.27	Facility		$71.55	$71.55	$72.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $74.41	Professional		$71.55	$71.55	$74.41
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $121.37 / $121.37	Facility		$80.00	$121.37	$121.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.50 / $71.55 / $71.55	Facility		$67.50	$71.55	$71.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $71.55	Professional		$71.55	$71.55	$71.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $104.18 / $202.50 / $390.68	Facility		$104.18	$202.50	$390.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $364.63 / $395.88 / $468.81	Professional		$364.63	$395.88	$468.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $71.55 / $71.55 / $151.69	Facility		$71.55	$71.55	$151.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $89.44	Professional		$71.55	$71.55	$89.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $25.80 / $205.54	Professional		$22.50	$25.80	$205.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.50 / $71.55 / $151.40	Facility		$67.50	$71.55	$151.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $79.81	Professional		$71.55	$71.55	$79.81
United Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $72.48	Professional		$71.55	$71.55	$72.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.55 / $71.55 / $96.59	Professional		$71.55	$71.55	$96.59