Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $194.98 / $616.60	Facility		$87.10	$194.98	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $141.25	Professional		$79.43	$100.00	$141.25
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 $87.10 / $102.33 / $602.56	Facility		$87.10	$102.33	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $162.18 / $194.98	Professional		$70.79	$162.18	$194.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $630.96	Facility		$630.96	$630.96	$630.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,000.00 / $1,000.00	Professional		$676.08	$1,000.00	$1,000.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $134.90 / $251.19	Facility		$102.33	$134.90	$251.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $165.96	Professional		$79.43	$107.15	$165.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $144.54 / $288.40	Professional		$131.83	$144.54	$288.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $134.90 / $371.54	Facility		$93.33	$134.90	$371.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $234.42	Professional		$79.43	$141.25	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $56.23 / $134.90	Facility		$47.86	$56.23	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $91.20	Professional		$56.23	$56.23	$91.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $134.90 / $134.90	Professional		$52.48	$134.90	$134.90