Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $662.69 / $675.81	Facility		$656.12	$662.69	$675.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $721.74	Professional		$656.12	$656.12	$721.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,456.92 / $5,821.21 / $8,577.84	Facility		$5,456.92	$5,821.21	$8,577.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $100.98 / $100.98	Professional		$100.98	$100.98	$100.98
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 $618.98 / $656.12 / $656.12	Facility		$618.98	$656.12	$656.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $656.12	Professional		$656.12	$656.12	$656.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $2,502.00 / $2,915.49	Facility		$1,417.80	$2,502.00	$2,915.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,838.00 / $5,838.00 / $5,838.00	Professional		$5,838.00	$5,838.00	$5,838.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $1,090.07 / $1,390.97	Facility		$656.12	$1,090.07	$1,390.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $820.15	Professional		$656.12	$656.12	$820.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.10 / $420.73 / $1,014.17	Professional		$148.10	$420.73	$1,014.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $1,390.97	Facility		$656.12	$656.12	$1,390.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $656.12	Professional		$656.12	$656.12	$656.12
United Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $664.65	Professional		$656.12	$656.12	$664.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $254.99 / $656.12 / $885.76	Professional		$254.99	$656.12	$885.76