Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.92 / $1,800.00 / $6,691.00	Facility		$88.92	$1,800.00	$6,691.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $518.00 / $590.88 / $934.53	Facility	50	$518.00	$590.88	$934.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $75.28 / $133.97	Professional		$51.90	$75.28	$133.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $143.94 / $166.50 / $492.13	Professional	50	$143.94	$166.50	$492.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.89 / $78.03 / $99.00	Professional		$51.89	$78.03	$99.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.77 / $114.72 / $150.37	Professional	50	$42.77	$114.72	$150.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.94 / $63.08 / $241.11	Facility		$36.94	$63.08	$241.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.97 / $73.59 / $104.80	Professional		$51.97	$73.59	$104.80
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $72.45 / $325.24 / $388.05	Facility		$72.45	$325.24	$388.05
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $92.04 / $129.41	Professional		$61.97	$92.04	$129.41
Christus Facility/Professional Facility Modifier Low / Median / High Price $48.46 / $249.66 / $249.66	Facility		$48.46	$249.66	$249.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.49 / $96.49 / $96.49	Facility		$96.49	$96.49	$96.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.50 / $91.11 / $142.06	Professional		$61.50	$91.11	$142.06
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $279.35	Facility		$55.00	$55.00	$279.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $408.88 / $613.73 / $703.20	Professional		$408.88	$613.73	$703.20
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $56.26 / $83.54 / $126.82	Facility		$56.26	$83.54	$126.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $71.90 / $102.88 / $144.27	Professional		$71.90	$102.88	$144.27
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $126.00 / $160.15 / $203.13	Professional	50	$126.00	$160.15	$203.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.91 / $100.78 / $206.40	Professional		$57.91	$100.78	$206.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.26 / $83.82 / $130.58	Facility		$56.26	$83.82	$130.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.38 / $95.19 / $153.94	Professional		$62.38	$95.19	$153.94
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $931.00 / $2,376.00	Facility		$161.00	$931.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.90 / $82.33 / $133.19	Professional		$60.90	$82.33	$133.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.02 / $78.03 / $109.19	Professional		$69.02	$78.03	$109.19