Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $488.00 / $2,017.00 / $5,556.00	Facility		$488.00	$2,017.00	$5,556.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,764.65 / $1,764.65 / $1,764.65	Facility	22	$1,764.65	$1,764.65	$1,764.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $396.84 / $1,018.00 / $14,483.00	Facility		$396.84	$1,018.00	$14,483.00
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $5.08 / $357.12 / $8,000.00	Facility		$5.08	$357.12	$8,000.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $344.32 / $370.66 / $370.66	Facility		$344.32	$370.66	$370.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.12 / $450.12 / $450.12	Facility		$450.12	$450.12	$450.12
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $276.13 / $276.13 / $276.13	Facility	62	$276.13	$276.13	$276.13
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $44.18 / $44.18 / $44.18	Facility	AS	$44.18	$44.18	$44.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,000.00 / $6,168.26	Facility		$55.00	$4,000.00	$6,168.26
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $532.83 / $1,126.85 / $1,168.08	Facility	62	$532.83	$1,126.85	$1,168.08
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $85.25 / $180.30 / $186.89	Facility	AS	$85.25	$180.30	$186.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $359.28 / $472.89 / $856.04	Facility		$359.28	$472.89	$856.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $359.54 / $472.89 / $812.88	Facility		$359.54	$472.89	$812.88
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $276.13 / $276.13 / $586.69	Facility	62	$276.13	$276.13	$586.69
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $150.19 / $150.19 / $150.19	Facility	80	$150.19	$150.19	$150.19
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $44.18 / $44.18 / $127.66	Facility	AS	$44.18	$44.18	$127.66
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $6,000.00 / $13,134.00	Facility		$2,093.00	$6,000.00	$13,134.00