Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,249.66	Facility		$1,237.28	$1,237.28	$1,249.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,298.53	Professional		$1,237.28	$1,237.28	$1,298.53
BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.18 / $8.18 / $22.40	Facility		$8.18	$8.18	$22.40
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 $80.00 / $121.37 / $121.37	Facility		$80.00	$121.37	$121.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,167.25 / $1,237.28 / $1,237.28	Facility		$1,167.25	$1,237.28	$1,237.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,237.28	Professional		$1,237.28	$1,237.28	$1,237.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,428.00 / $2,408.92 / $5,119.78	Facility		$1,428.00	$2,408.92	$5,119.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,119.78 / $5,119.78 / $5,563.22	Professional		$5,119.78	$5,119.78	$5,563.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $106.56 / $1,237.28 / $2,623.03	Facility		$106.56	$1,237.28	$2,623.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,546.60	Professional		$1,237.28	$1,237.28	$1,546.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.10 / $1,336.27 / $2,609.13	Professional		$148.10	$1,336.27	$2,609.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $2,618.03	Facility		$1,237.28	$1,237.28	$2,618.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,572.54	Professional		$1,237.28	$1,237.28	$1,572.54
United Facility/Professional Professional Modifier Low / Median / High Price $1,237.28 / $1,237.28 / $1,237.28	Professional		$1,237.28	$1,237.28	$1,237.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,159.60 / $1,237.28 / $1,670.33	Professional		$1,159.60	$1,237.28	$1,670.33