Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.65 / $1,861.00 / $6,261.00	Facility		$85.65	$1,861.00	$6,261.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,356.33 / $1,562.32 / $1,814.84	Facility	50	$1,356.33	$1,562.32	$1,814.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $76.20 / $138.32	Professional		$47.53	$76.20	$138.32
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $138.55 / $317.07	Professional	50	$74.13	$138.55	$317.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.04 / $84.26 / $107.59	Professional		$56.04	$84.26	$107.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $126.40 / $126.40 / $139.03	Professional	50	$126.40	$126.40	$139.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.17 / $67.84 / $259.33	Facility		$41.17	$67.84	$259.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.65 / $81.62 / $129.38	Professional		$47.65	$81.62	$129.38
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $51.54 / $93.94 / $666.01	Facility		$51.54	$93.94	$666.01
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $83.72 / $113.75 / $155.88	Professional		$83.72	$113.75	$155.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $44.18 / $885.58 / $885.58	Facility		$44.18	$885.58	$885.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.02 / $89.02 / $89.02	Facility		$89.02	$89.02	$89.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $94.80 / $153.58	Professional		$57.11	$94.80	$153.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $252.75	Facility		$55.00	$55.00	$252.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $377.68 / $432.23 / $754.73	Professional		$377.68	$432.23	$754.73
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.41 / $85.65 / $137.47	Facility		$50.41	$85.65	$137.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $102.45 / $155.90	Professional		$65.59	$102.45	$155.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.89 / $89.31 / $174.26	Professional		$48.89	$89.31	$174.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.41 / $86.49 / $141.91	Facility		$50.41	$86.49	$141.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $97.84 / $163.87	Professional		$58.23	$97.84	$163.87
United Facility/Professional Facility Modifier Low / Median / High Price $374.00 / $1,529.00 / $3,400.00	Facility		$374.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $87.79 / $141.63	Professional		$65.06	$87.79	$141.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.54 / $84.26 / $118.17	Professional		$74.54	$84.26	$118.17