Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $138.04	Professional		$107.15	$131.83	$138.04
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 $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $131.83 / $234.42	Facility		$112.20	$131.83	$234.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $131.83	Professional		$107.15	$131.83	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $131.83 / $229.09	Facility		$109.65	$131.83	$229.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $79.43	Professional		$60.26	$79.43	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $28.84	Professional		$23.44	$23.44	$28.84