Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $85.11	Professional		$77.62	$77.62	$85.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,548.13 / $4,265.80	Facility		$3,162.28	$3,548.13	$4,265.80
Christus Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $120.23 / $125.89	Facility		$77.62	$120.23	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $77.62 / $77.62	Facility		$74.13	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Facility		$380.19	$380.19	$380.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $81.28 / $165.96	Facility		$77.62	$81.28	$165.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $81.28 / $223.87	Professional		$77.62	$81.28	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $32.36 / $85.11	Professional		$30.20	$32.36	$85.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $128.82	Professional		$104.71	$104.71	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $81.28 / $194.98	Facility		$77.62	$81.28	$194.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $125.89	Professional		$77.62	$107.15	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $125.89 / $125.89	Professional		$120.23	$125.89	$125.89