Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,071.52	Facility		$1,047.13	$1,047.13	$1,071.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,096.48	Professional		$1,047.13	$1,047.13	$1,096.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Professional		$891.25	$891.25	$891.25
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $120.23 / $1,047.13	Facility		$79.43	$120.23	$1,047.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,047.13 / $1,047.13	Facility		$1,000.00	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility		$1,862.09	$1,862.09	$1,862.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $4,466.84	Professional		$4,466.84	$4,466.84	$4,466.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $1,047.13 / $1,905.46	Facility		$194.98	$1,047.13	$1,905.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $1,047.13 / $1,096.48	Professional		$158.49	$1,047.13	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $295.12	Professional		$32.36	$33.11	$295.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $1,412.54	Professional		$489.78	$489.78	$1,412.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $1,047.13 / $1,862.09	Facility		$223.87	$1,047.13	$1,862.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $257.04 / $1,000.00	Professional		$125.89	$257.04	$1,000.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $302.00	Professional		$125.89	$125.89	$302.00