Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $169.82 / $169.82	Facility		$165.96	$169.82	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $181.97	Professional		$165.96	$173.78	$181.97
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $120.23 / $125.89	Facility		$79.43	$120.23	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Professional		$933.25	$933.25	$933.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $199.53 / $309.03	Facility		$154.88	$199.53	$309.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $223.87	Professional		$162.18	$173.78	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $33.11	Professional		$30.20	$30.20	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $302.00	Professional		$204.17	$245.47	$302.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $208.93 / $354.81	Facility		$165.96	$208.93	$354.81
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 $125.89 / $162.18 / $204.17	Professional		$125.89	$162.18	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89