Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.09 / $215.57 / $263.97	Professional		$141.09	$215.57	$263.97
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $80.00	Facility		$80.00	$80.00	$80.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.53 / $108.53 / $108.53	Professional		$108.53	$108.53	$108.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $428.07 / $510.00 / $1,264.50	Facility		$428.07	$510.00	$1,264.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,492.23 / $1,492.23 / $2,260.94	Professional		$1,492.23	$1,492.23	$2,260.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $181.29 / $235.95 / $301.45	Facility		$181.29	$235.95	$301.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $203.49 / $214.80 / $256.24	Professional		$203.49	$214.80	$256.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $307.49 / $361.75	Professional		$301.45	$307.49	$361.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $182.13 / $237.99 / $301.45	Facility		$182.13	$237.99	$301.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.53 / $108.53 / $215.20	Professional		$108.53	$108.53	$215.20
United Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $139.06 / $161.83	Professional		$94.00	$139.06	$161.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $406.97	Professional		$301.45	$301.45	$406.97