Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.08 / $162.08 / $163.69	Facility		$162.08	$162.08	$163.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.66 / $162.08 / $163.69	Professional		$129.66	$162.08	$163.69
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 $162.08 / $162.08 / $162.08	Facility		$162.08	$162.08	$162.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $162.08	Professional		$162.08	$162.08	$162.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $162.08 / $162.08 / $163.61	Facility		$162.08	$162.08	$163.61
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $238.54 / $238.54 / $238.54	Professional		$238.54	$238.54	$238.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $132.25 / $162.08 / $281.75	Facility		$132.25	$162.08	$281.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.10 / $225.29 / $364.68	Professional		$148.10	$225.29	$364.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.08 / $162.08 / $343.61	Facility		$162.08	$162.08	$343.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $162.08	Professional		$162.08	$162.08	$162.08
United Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $164.19	Professional		$162.08	$162.08	$164.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.08 / $162.08 / $218.81	Professional		$162.08	$162.08	$218.81