Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $123.00 / $123.00	Facility		$120.00	$123.00	$123.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $123.00 / $127.50	Professional		$120.00	$123.00	$127.50
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 $127.50 / $127.50 / $127.50	Facility		$127.50	$127.50	$127.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $217.50 / $562.50	Facility		$150.00	$217.50	$562.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $330.00 / $570.00 / $570.00	Professional		$330.00	$570.00	$570.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $122.40 / $150.00 / $260.76	Facility		$122.40	$150.00	$260.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.10 / $205.54 / $302.94	Professional		$148.10	$205.54	$302.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.00 / $150.00 / $260.76	Facility		$123.00	$150.00	$260.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
United Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Professional		$150.00	$150.00	$150.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $172.13	Professional		$127.50	$127.50	$172.13