Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $112.26	Facility		$111.15	$111.15	$112.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $130.26	Professional		$111.15	$111.15	$130.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $12.17 / $33.76	Facility		$8.69	$12.17	$33.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.18 / $8.18 / $8.18	Professional		$8.18	$8.18	$8.18
Christus Facility/Professional Facility Modifier Low / Median / High Price $117.28 / $121.37 / $121.37	Facility		$117.28	$121.37	$121.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.86 / $111.15 / $111.15	Facility		$104.86	$111.15	$111.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Professional		$111.15	$111.15	$111.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $474.00 / $1,606.18 / $1,606.18	Facility		$474.00	$1,606.18	$1,606.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,606.18 / $1,606.18 / $1,606.18	Professional		$1,606.18	$1,606.18	$1,606.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.26 / $130.26 / $235.64	Facility		$112.26	$130.26	$235.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $138.94	Professional		$111.15	$111.15	$138.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.04 / $205.54 / $818.52	Professional		$120.04	$205.54	$818.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $237.99	Facility		$111.15	$111.15	$237.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $387.48	Professional		$111.15	$111.15	$387.48
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $112.59	Professional		$111.15	$111.15	$112.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $363.79	Professional		$111.15	$111.15	$363.79