Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $748.00 / $2,700.00 / $7,918.00	Facility		$748.00	$2,700.00	$7,918.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $721.93 / $965.37 / $1,481.27	Professional		$721.93	$965.37	$1,481.27
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $25.02 / $121.98 / $920.60	Professional	AS	$25.02	$121.98	$920.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $423.16 / $992.66 / $1,090.83	Professional		$423.16	$992.66	$1,090.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,500.92 / $4,674.35 / $8,872.32	Facility		$2,500.92	$4,674.35	$8,872.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $769.95 / $1,007.12 / $1,430.02	Professional		$769.95	$1,007.12	$1,430.02
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,101.44 / $3,621.06 / $8,715.36	Facility		$1,101.44	$3,621.06	$8,715.36
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $1,077.08 / $1,214.95 / $1,953.60	Professional		$1,077.08	$1,214.95	$1,953.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $750.64 / $3,150.27 / $3,150.27	Facility		$750.64	$3,150.27	$3,150.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $883.34 / $1,168.22 / $1,790.75	Professional		$883.34	$1,168.22	$1,790.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $5,958.84	Facility		$55.00	$55.00	$5,958.84
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $397.38 / $436.07 / $436.07	Facility	AS	$397.38	$436.07	$436.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,285.28 / $7,812.24 / $9,170.62	Professional		$6,285.28	$7,812.24	$9,170.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $815.92 / $1,060.58 / $1,530.39	Facility		$815.92	$1,060.58	$1,530.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $995.99 / $1,440.63 / $1,964.36	Professional		$995.99	$1,440.63	$1,964.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $821.60 / $1,081.00 / $1,479.07	Professional		$821.60	$1,081.00	$1,479.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $815.92 / $1,059.83 / $1,543.94	Facility		$815.92	$1,059.83	$1,543.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $926.04 / $1,221.79 / $1,969.08	Professional		$926.04	$1,221.79	$1,969.08
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $267.79 / $278.22 / $392.25	Professional	AS	$267.79	$278.22	$392.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,425.00 / $10,600.00	Facility		$1,634.00	$4,425.00	$10,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $835.30 / $1,113.73 / $1,693.98	Professional		$835.30	$1,113.73	$1,693.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $901.36 / $1,019.80 / $1,426.25	Professional		$901.36	$1,019.80	$1,426.25