Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.84	Facility		$80.04	$80.04	$80.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $84.88	Professional		$80.04	$80.04	$84.88
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 $75.51 / $80.04 / $80.04	Facility		$75.51	$80.04	$80.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Professional		$80.04	$80.04	$80.04
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $500.65 / $883.50 / $2,756.52	Facility		$500.65	$883.50	$2,756.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,756.52 / $2,756.52 / $2,756.52	Professional		$2,756.52	$2,756.52	$2,756.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $169.68	Facility		$80.04	$80.04	$169.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $100.05	Professional		$80.04	$80.04	$100.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.44 / $205.54 / $1,404.77	Professional		$86.44	$205.54	$1,404.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $171.38	Facility		$80.04	$80.04	$171.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $113.26	Professional		$80.04	$80.04	$113.26
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $81.08	Professional		$80.04	$80.04	$81.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $624.34	Professional		$80.04	$80.04	$624.34