Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $91.54 / $92.45	Facility		$91.54	$91.54	$92.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $94.29	Professional		$91.54	$91.54	$94.29
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 $86.36 / $91.54 / $91.54	Facility		$86.36	$91.54	$91.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $91.54	Professional		$91.54	$91.54	$91.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $136.00 / $304.81 / $304.81	Facility		$136.00	$304.81	$304.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $304.81 / $304.81 / $304.81	Professional		$304.81	$304.81	$304.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $67.72 / $91.54 / $194.06	Facility		$67.72	$91.54	$194.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $114.43	Professional		$91.54	$91.54	$114.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $98.86 / $127.24 / $302.94	Professional		$98.86	$127.24	$302.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.54 / $91.54 / $193.69	Facility		$91.54	$91.54	$193.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $91.54	Professional		$91.54	$91.54	$91.54
United Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $91.54 / $93.92	Professional		$91.54	$91.54	$93.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.72 / $91.54 / $123.58	Professional		$67.72	$91.54	$123.58