Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $651.00 / $3,162.00 / $8,883.40	Facility		$651.00	$3,162.00	$8,883.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,999.00 / $3,088.50 / $4,665.00	Facility	50	$2,999.00	$3,088.50	$4,665.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.55 / $482.56 / $843.60	Professional		$371.55	$482.56	$843.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $402.77 / $442.61 / $654.66	Professional		$402.77	$442.61	$654.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,450.03 / $4,544.33 / $9,058.35	Facility		$2,450.03	$4,544.33	$9,058.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $429.14 / $571.79 / $890.52	Professional		$429.14	$571.79	$890.52
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $221.70 / $1,345.80 / $4,050.00	Facility		$221.70	$1,345.80	$4,050.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $442.61 / $589.37 / $759.38	Professional		$442.61	$589.37	$759.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $440.21 / $4,089.09 / $4,089.09	Facility		$440.21	$4,089.09	$4,089.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,207.78 / $2,207.78 / $2,207.78	Facility		$2,207.78	$2,207.78	$2,207.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $494.00 / $671.21 / $1,028.80	Professional		$494.00	$671.21	$1,028.80
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,301.42 / $26,542.00 / $26,542.00	Facility		$2,301.42	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,310.40 / $4,095.36 / $4,958.93	Professional		$3,310.40	$4,095.36	$4,958.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $435.53 / $590.52 / $1,010.82	Facility		$435.53	$590.52	$1,010.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $593.33 / $753.08 / $1,013.09	Professional		$593.33	$753.08	$1,013.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $456.99 / $774.57 / $1,722.81	Professional		$456.99	$774.57	$1,722.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $436.41 / $591.99 / $1,148.73	Facility		$436.41	$591.99	$1,148.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $501.56 / $692.68 / $1,167.84	Professional		$501.56	$692.68	$1,167.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,314.00 / $7,600.00	Facility		$1,154.00	$3,314.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $434.43 / $586.34 / $940.11	Professional		$434.43	$586.34	$940.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $480.36 / $543.16 / $756.72	Professional		$480.36	$543.16	$756.72