Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $3,792.00 / $13,375.00	Facility		$1,152.00	$3,792.00	$13,375.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $11,316.60 / $11,316.60 / $18,463.20	Facility	22	$11,316.60	$11,316.60	$18,463.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,163.54 / $17,137.02 / $42,485.53	Facility		$9,163.54	$17,137.02	$42,485.53
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $2,218.36 / $14,176.43 / $24,939.81	Facility		$2,218.36	$14,176.43	$24,939.81
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,559.69 / $15,658.42 / $15,658.42	Facility		$1,559.69	$15,658.42	$15,658.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,938.95 / $1,938.95 / $1,938.95	Facility		$1,938.95	$1,938.95	$1,938.95
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,200.02 / $1,200.02 / $1,200.02	Facility	62	$1,200.02	$1,200.02	$1,200.02
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $192.00 / $192.00 / $192.00	Facility	AS	$192.00	$192.00	$192.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $39,500.00 / $51,439.50	Facility		$55.00	$39,500.00	$51,439.50
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,306.98 / $30,473.31 / $30,473.31	Facility	62	$2,306.98	$30,473.31	$30,473.31
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $369.12 / $4,875.72 / $4,875.72	Facility	AS	$369.12	$4,875.72	$4,875.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,553.87 / $2,022.15 / $3,552.94	Facility		$1,553.87	$2,022.15	$3,552.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,570.63 / $2,040.68 / $3,552.94	Facility		$1,570.63	$2,040.68	$3,552.94
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,200.02 / $1,200.02 / $2,534.46	Facility	62	$1,200.02	$1,200.02	$2,534.46
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $648.82 / $648.82 / $648.82	Facility	80	$648.82	$648.82	$648.82
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $192.00 / $192.00 / $551.50	Facility	AS	$192.00	$192.00	$551.50
United Facility/Professional Facility Modifier Low / Median / High Price $2,600.00 / $7,184.00 / $16,000.00	Facility		$2,600.00	$7,184.00	$16,000.00