Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $933.25 / $2,884.03	Facility		$416.87	$933.25	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $489.78 / $676.08	Professional		$380.19	$489.78	$676.08
Christus Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $489.78 / $2,884.03	Facility		$416.87	$489.78	$2,884.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $707.95 / $891.25	Professional		$676.08	$707.95	$891.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility		$3,019.95	$3,019.95	$3,019.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $645.65 / $1,258.93	Facility		$426.58	$645.65	$1,258.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $776.25	Professional		$380.19	$512.86	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Professional		$478.63	$478.63	$478.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $645.65 / $1,479.11	Facility		$436.52	$645.65	$1,479.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $602.56 / $676.08	Professional		$79.43	$602.56	$676.08
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $302.00 / $645.65	Facility		$229.09	$302.00	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $645.65	Professional		$269.15	$269.15	$645.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $1,230.27	Professional		$645.65	$645.65	$1,230.27