Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $1,513.56 / $6,165.95	Facility		$295.12	$1,513.56	$6,165.95
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	52	$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $478.63	Professional		$85.11	$138.04	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $177.83	Professional		$77.62	$120.23	$177.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $120.23 / $512.86	Facility		$74.13	$120.23	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $162.18	Professional		$79.43	$109.65	$162.18
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $162.18 / $2,041.74	Facility		$58.88	$162.18	$2,041.74
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $123.03 / $218.78	Professional		$63.10	$123.03	$218.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $123.03 / $125.89	Facility		$89.13	$123.03	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $213.80	Professional		$102.33	$141.25	$213.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $1,659.59	Facility		$54.95	$56.23	$1,659.59
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	52	$478.63	$478.63	$478.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,096.48 / $1,096.48	Professional		$933.25	$1,096.48	$1,096.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $154.88 / $3,630.78	Facility		$89.13	$154.88	$3,630.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $263.03	Professional		$87.10	$141.25	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $120.23 / $190.55	Facility		$83.18	$120.23	$190.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $218.78	Professional		$102.33	$147.91	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $1,047.13 / $2,691.53	Facility		$162.18	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $165.96	Professional		$81.28	$114.82	$165.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89