Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $735.05 / $742.40	Facility		$735.05	$735.05	$742.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $821.34	Professional		$735.05	$735.05	$821.34
Christus Facility/Professional Facility Modifier Low / Median / High Price $121.37 / $121.37 / $127.00	Facility		$121.37	$121.37	$127.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $693.44 / $735.05 / $735.05	Facility		$693.44	$735.05	$735.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $735.05	Professional		$735.05	$735.05	$735.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,887.00 / $4,295.12 / $4,440.00	Facility		$1,887.00	$4,295.12	$4,440.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,295.12 / $4,295.12 / $8,436.00	Professional		$4,295.12	$4,295.12	$8,436.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $742.40 / $813.21 / $1,558.31	Facility		$742.40	$813.21	$1,558.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $918.81	Professional		$735.05	$735.05	$918.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.10 / $302.94 / $2,188.88	Professional		$148.10	$302.94	$2,188.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $735.05 / $735.05 / $1,555.34	Facility		$735.05	$735.05	$1,555.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $1,040.16	Professional		$735.05	$735.05	$1,040.16
United Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $744.61	Professional		$735.05	$735.05	$744.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $735.05 / $735.05 / $813.21	Professional		$735.05	$735.05	$813.21