Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $52.48 / $52.48	Facility		$14.13	$52.48	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $16.98	Professional		$14.13	$14.13	$16.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,548.13 / $4,265.80	Facility		$3,162.28	$3,548.13	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
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 $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $100.00	Professional		$93.33	$93.33	$100.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $14.79 / $35.48	Facility		$14.13	$14.79	$35.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $16.98	Professional		$14.13	$14.13	$16.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $83.18 / $102.33	Professional		$30.20	$83.18	$102.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $17.38 / $61.66	Facility		$14.13	$17.38	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $77.62	Professional		$61.66	$61.66	$77.62