Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $69.17	Facility		$68.48	$68.48	$69.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $72.63	Professional		$68.48	$68.48	$72.63
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 $64.61 / $68.48 / $68.48	Facility		$64.61	$68.48	$68.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Professional		$68.48	$68.48	$68.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $91.10 / $302.37 / $302.37	Facility		$91.10	$302.37	$302.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $302.37 / $302.37 / $335.66	Professional		$302.37	$302.37	$335.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $145.19	Facility		$68.48	$68.48	$145.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $85.61	Professional		$68.48	$68.48	$85.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.97 / $130.46 / $302.94	Professional		$73.97	$130.46	$302.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $144.91	Facility		$68.48	$68.48	$144.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $83.39	Professional		$68.48	$68.48	$83.39
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Professional		$68.48	$68.48	$68.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $92.46	Professional		$68.48	$68.48	$92.46