Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $56.23	Facility		$54.95	$56.23	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.23 / $58.88	Professional		$54.95	$56.23	$58.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $58.88 / $100.00	Facility		$54.95	$58.88	$100.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.23 / $64.57	Professional		$54.95	$56.23	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $50.12	Professional		$30.20	$30.20	$50.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $69.18 / $120.23	Facility		$56.23	$69.18	$120.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88