Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.03 / $101.03 / $102.04	Facility		$101.03	$101.03	$102.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $110.12	Professional		$101.03	$101.03	$110.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.65 / $181.44 / $443.52	Facility		$123.65	$181.44	$443.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $62.50	Professional		$62.50	$62.50	$62.50
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 $95.31 / $101.03 / $101.03	Facility		$95.31	$101.03	$101.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $101.03	Professional		$101.03	$101.03	$101.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $174.32 / $547.60 / $547.60	Facility		$174.32	$547.60	$547.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $466.64 / $466.64 / $466.64	Professional		$466.64	$466.64	$466.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $98.54 / $101.03 / $221.50	Facility		$98.54	$101.03	$221.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $126.29	Professional		$101.03	$101.03	$126.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $140.43 / $205.54 / $249.00	Professional		$140.43	$205.54	$249.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $101.03 / $101.03 / $221.08	Facility		$101.03	$101.03	$221.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $126.42	Professional		$101.03	$101.03	$126.42
United Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $101.03	Professional		$101.03	$101.03	$101.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $136.38	Professional		$101.03	$101.03	$136.38