Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $742.69 / $3,303.00 / $10,481.00	Facility		$742.69	$3,303.00	$10,481.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $825.75 / $2,152.50 / $4,621.50	Facility	50	$825.75	$2,152.50	$4,621.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $538.20 / $700.34 / $1,137.38	Professional		$538.20	$700.34	$1,137.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,432.62 / $4,348.17 / $5,685.00	Professional	50	$1,432.62	$4,348.17	$5,685.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $321.12 / $321.12 / $642.23	Professional		$321.12	$321.12	$642.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $481.67 / $481.67 / $481.67	Professional	50	$481.67	$481.67	$481.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,544.82 / $4,756.39 / $9,083.70	Facility		$2,544.82	$4,756.39	$9,083.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $624.37 / $831.33 / $1,316.54	Professional		$624.37	$831.33	$1,316.54
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $207.90 / $1,251.50 / $4,050.00	Facility		$207.90	$1,251.50	$4,050.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $330.89 / $555.04 / $669.38	Professional		$330.89	$555.04	$669.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $600.04 / $6,626.38 / $6,626.38	Facility		$600.04	$6,626.38	$6,626.38
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 $733.20 / $994.60 / $1,543.93	Professional		$733.20	$994.60	$1,543.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,645.50 / $26,542.00 / $26,542.00	Facility		$4,645.50	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,882.72 / $5,999.28 / $7,101.53	Professional		$4,882.72	$5,999.28	$7,101.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $667.50 / $937.56 / $1,574.25	Facility		$667.50	$937.56	$1,574.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $862.03 / $1,094.11 / $1,466.06	Professional		$862.03	$1,094.11	$1,466.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $724.37 / $1,268.32 / $2,534.62	Professional		$724.37	$1,268.32	$2,534.62
Providence Facility/Professional Facility Modifier Low / Median / High Price $672.56 / $948.20 / $1,800.43	Facility		$672.56	$948.20	$1,800.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $753.44 / $1,025.26 / $1,749.77	Professional		$753.44	$1,025.26	$1,749.77
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 $687.72 / $933.36 / $1,461.41	Professional		$687.72	$933.36	$1,461.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $695.13 / $785.29 / $1,099.20	Professional		$695.13	$785.29	$1,099.20