Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $398.11 / $1,258.93	Facility		$165.96	$398.11	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $208.93 / $275.42	Professional		$162.18	$208.93	$275.42
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 $162.18 / $398.11 / $1,230.27	Facility		$162.18	$398.11	$1,230.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $398.11	Professional		$331.13	$331.13	$398.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $2,041.74 / $2,041.74	Professional		$1,380.38	$2,041.74	$2,041.74
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $275.42 / $512.86	Facility		$208.93	$275.42	$512.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $316.23	Professional		$162.18	$218.78	$316.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $295.12 / $588.84	Professional		$275.42	$295.12	$588.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $275.42 / $758.58	Facility		$186.21	$275.42	$758.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $302.00 / $426.58	Professional		$245.47	$302.00	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $114.82 / $275.42	Facility		$100.00	$114.82	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $169.82	Professional		$104.71	$104.71	$169.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $275.42 / $275.42	Professional		$107.15	$275.42	$275.42