Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $1,682.00 / $5,332.00	Facility		$425.00	$1,682.00	$5,332.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $27.78 / $33.03 / $61.95	Facility	52	$27.78	$33.03	$61.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.99 / $107.64 / $212.02	Professional		$61.99	$107.64	$212.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $124.50 / $161.85	Professional		$68.87	$124.50	$161.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.34 / $116.36 / $627.28	Facility		$71.34	$116.36	$627.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.45 / $122.26 / $204.27	Professional		$67.45	$122.26	$204.27
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $547.52 / $1,038.40 / $8,000.00	Facility		$547.52	$1,038.40	$8,000.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $121.39 / $168.32 / $230.33	Professional		$121.39	$168.32	$230.33
Christus Facility/Professional Facility Modifier Low / Median / High Price $61.74 / $583.75 / $583.75	Facility		$61.74	$583.75	$583.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $542.02 / $542.02 / $542.02	Facility		$542.02	$542.02	$542.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.65 / $146.62 / $234.47	Professional		$82.65	$146.62	$234.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $328.49 / $351.60 / $351.60	Facility		$328.49	$351.60	$351.60
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $262.79 / $281.27 / $281.27	Facility	52	$262.79	$281.27	$281.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $529.12 / $597.08 / $1,111.88	Professional		$529.12	$597.08	$1,111.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.87 / $129.47 / $274.29	Facility		$68.87	$129.47	$274.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.25 / $167.78 / $232.31	Professional		$91.25	$167.78	$232.31
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $768.13 / $1,034.96 / $5,135.46	Facility		$768.13	$1,034.96	$5,135.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.63 / $154.69 / $297.31	Professional		$77.63	$154.69	$297.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.87 / $128.97 / $273.76	Facility		$68.87	$128.97	$273.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $84.55 / $149.41 / $245.29	Professional		$84.55	$149.41	$245.29
United Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $1,529.00 / $3,400.00	Facility		$369.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $105.96 / $142.32 / $225.17	Professional		$105.96	$142.32	$225.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $110.15 / $124.50 / $174.80	Professional		$110.15	$124.50	$174.80