Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $241.77 / $918.86 / $4,008.00	Facility		$241.77	$918.86	$4,008.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $490.95 / $814.61 / $3,429.00	Facility	50	$490.95	$814.61	$3,429.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.73 / $27.43 / $41.87	Facility	52	$18.73	$27.43	$41.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $64.73 / $126.79	Professional		$42.34	$64.73	$126.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $65.55 / $121.27 / $298.08	Professional	50	$65.55	$121.27	$298.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $62.30 / $80.88	Professional		$42.93	$62.30	$80.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $74.20 / $97.42 / $129.85	Professional	50	$74.20	$97.42	$129.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.18 / $41.59 / $134.40	Facility		$29.18	$41.59	$134.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.96 / $57.08 / $82.22	Professional		$40.96	$57.08	$82.22
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $26.91 / $75.69 / $1,643.04	Facility		$26.91	$75.69	$1,643.04
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $36.59 / $69.73 / $104.16	Professional		$36.59	$69.73	$104.16
Christus Facility/Professional Facility Modifier Low / Median / High Price $39.03 / $255.95 / $255.95	Facility		$39.03	$255.95	$255.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.04 / $77.04 / $77.04	Facility		$77.04	$77.04	$77.04
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.48 / $73.81 / $122.34	Professional		$49.48	$73.81	$122.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $220.97 / $15,000.00	Facility		$55.00	$220.97	$15,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $164.70 / $176.78 / $176.78	Facility	52	$164.70	$176.78	$176.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $325.76 / $468.88 / $550.50	Professional		$325.76	$468.88	$550.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $45.93 / $70.51 / $118.86	Facility		$45.93	$70.51	$118.86
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.09 / $85.35 / $117.92	Professional		$56.09	$85.35	$117.92
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $77.00 / $125.96 / $172.61	Professional	50	$77.00	$125.96	$172.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $103.61 / $574.66 / $1,759.00	Facility		$103.61	$574.66	$1,759.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $68.90 / $126.30	Professional		$42.93	$68.90	$126.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.87 / $70.45 / $114.77	Facility		$45.87	$70.45	$114.77
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $77.37 / $124.97	Professional		$51.00	$77.37	$124.97
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $2,405.00	Facility		$161.00	$950.00	$2,405.00
United Facility/Professional Professional Modifier Low / Median / High Price $51.10 / $68.38 / $109.20	Professional		$51.10	$68.38	$109.20
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $85.00 / $156.00	Professional	50	$80.00	$85.00	$156.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.11 / $61.27 / $85.59	Professional		$54.11	$61.27	$85.59