Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $389.05 / $389.05	Facility		$380.19	$389.05	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $398.11 / $407.38	Professional		$380.19	$398.11	$407.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $120.23 / $125.89	Facility		$79.43	$120.23	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Facility		$407.38	$407.38	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $407.38 / $407.38	Professional		$407.38	$407.38	$407.38
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility		$1,445.44	$1,445.44	$1,445.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,137.96	Professional		$2,137.96	$2,137.96	$2,137.96
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $407.38 / $676.08	Facility		$141.25	$407.38	$676.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $380.19 / $407.38	Professional		$162.18	$380.19	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $44.67	Professional		$30.20	$30.20	$44.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $302.00	Professional		$204.17	$245.47	$302.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $478.63 / $707.95	Facility		$190.55	$478.63	$707.95
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 / $251.19 / $478.63	Professional		$125.89	$251.19	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $125.89 / $125.89	Professional		$120.23	$125.89	$125.89