Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $1,584.89 / $8,128.31	Facility		$151.36	$1,584.89	$8,128.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $398.11	Professional		$151.36	$151.36	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $128.82	Professional		$114.82	$128.82	$128.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $467.74	Facility		$162.18	$162.18	$467.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Christus Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $288.40 / $288.40	Facility		$120.23	$288.40	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $151.36 / $151.36	Facility		$141.25	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $346.74	Facility		$151.36	$151.36	$346.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $154.88 / $229.09	Professional		$151.36	$154.88	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $151.36 / $158.49	Professional		$33.11	$151.36	$158.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $346.74 / $346.74	Professional		$251.19	$346.74	$346.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $363.08	Facility		$151.36	$151.36	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $131.83	Professional		$125.89	$125.89	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $331.13	Professional		$125.89	$158.49	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $125.89 / $158.49	Professional		$120.23	$125.89	$158.49