Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $279.25 / $1,645.00 / $6,000.00	Facility		$279.25	$1,645.00	$6,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.78 / $210.47 / $364.87	Professional		$132.78	$210.47	$364.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $220.68 / $257.06 / $315.26	Professional		$220.68	$257.06	$315.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.31 / $217.73 / $888.65	Facility		$140.31	$217.73	$888.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.47 / $212.02 / $337.39	Professional		$135.47	$212.02	$337.39
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $288.77 / $2,413.35	Facility		$125.00	$288.77	$2,413.35
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $82.33 / $151.57 / $330.16	Professional		$82.33	$151.57	$330.16
Christus Facility/Professional Facility Modifier Low / Median / High Price $130.09 / $236.06 / $247.10	Facility		$130.09	$236.06	$247.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.59 / $258.18 / $390.24	Professional		$160.59	$258.18	$390.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,065.59	Facility		$55.00	$55.00	$1,065.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,103.59 / $1,878.96 / $2,191.58	Professional		$1,103.59	$1,878.96	$2,191.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $221.43 / $343.36	Facility		$141.60	$221.43	$343.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $175.50 / $295.64 / $459.28	Professional		$175.50	$295.64	$459.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $136.03 / $242.48 / $303.27	Professional		$136.03	$242.48	$303.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $221.43 / $345.94	Facility		$141.60	$221.43	$345.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $169.39 / $272.35 / $437.98	Professional		$169.39	$272.35	$437.98
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 $188.66 / $254.73 / $366.40	Professional		$188.66	$254.73	$366.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $215.89 / $242.51 / $339.51	Professional		$215.89	$242.51	$339.51