Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $243.64 / $1,800.00 / $6,000.00	Facility		$243.64	$1,800.00	$6,000.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $104.72 / $142.72 / $241.33	Facility	54	$104.72	$142.72	$241.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.69 / $189.24 / $347.68	Professional		$143.69	$189.24	$347.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.01 / $220.20 / $311.70	Professional		$183.01	$220.20	$311.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.14 / $167.46 / $643.28	Facility		$90.14	$167.46	$643.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.10 / $204.03 / $296.91	Professional		$151.10	$204.03	$296.91
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $177.45 / $321.77 / $525.21	Facility		$177.45	$321.77	$525.21
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $118.68 / $235.18 / $323.69	Professional		$118.68	$235.18	$323.69
Christus Facility/Professional Facility Modifier Low / Median / High Price $168.91 / $206.30 / $212.65	Facility		$168.91	$206.30	$212.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.84 / $241.33 / $348.41	Professional		$186.84	$241.33	$348.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $939.55	Facility		$55.00	$55.00	$939.55
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $589.19 / $657.69 / $657.69	Facility	54	$589.19	$657.69	$657.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,342.08 / $1,552.00 / $1,797.30	Professional		$1,342.08	$1,552.00	$1,797.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $167.59 / $209.44 / $296.44	Facility		$167.59	$209.44	$296.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $208.31 / $291.63 / $374.96	Professional		$208.31	$291.63	$374.96
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $665.00 / $947.00 / $3,207.00	Facility		$665.00	$947.00	$3,207.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $174.21 / $212.45 / $266.20	Professional		$174.21	$212.45	$266.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $167.59 / $209.23 / $296.44	Facility		$167.59	$209.23	$296.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $193.27 / $254.86 / $384.75	Professional		$193.27	$254.86	$384.75
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $952.00 / $2,405.00	Facility		$161.00	$952.00	$2,405.00
United Facility/Professional Professional Modifier Low / Median / High Price $158.66 / $213.83 / $316.42	Professional		$158.66	$213.83	$316.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.79 / $201.11 / $281.55	Professional		$177.79	$201.11	$281.55