Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $2,017.00 / $6,762.00	Facility		$425.00	$2,017.00	$6,762.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,530.43 / $3,530.43 / $3,530.43	Facility	22	$3,530.43	$3,530.43	$3,530.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.55 / $264.08 / $779.45	Professional		$225.55	$264.08	$779.45
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $52.06 / $87.00 / $174.76	Professional	AS	$52.06	$87.00	$174.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $243.68 / $282.66 / $321.66	Professional		$243.68	$282.66	$321.66
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $40.43 / $43.08 / $43.75	Professional	AS	$40.43	$43.08	$43.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,845.00 / $12,723.00 / $19,343.00	Facility		$1,845.00	$12,723.00	$19,343.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.59 / $255.31 / $398.13	Professional		$205.59	$255.31	$398.13
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $243.75 / $1,598.40 / $8,000.00	Facility		$243.75	$1,598.40	$8,000.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $249.83 / $331.40 / $433.92	Professional		$249.83	$331.40	$433.92
Christus Facility/Professional Facility Modifier Low / Median / High Price $223.24 / $241.69 / $241.69	Facility		$223.24	$241.69	$241.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $292.55 / $292.55 / $292.55	Facility		$292.55	$292.55	$292.55
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $179.42 / $179.42 / $179.42	Facility	62	$179.42	$179.42	$179.42
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $28.71 / $28.71 / $28.71	Facility	AS	$28.71	$28.71	$28.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.93 / $350.02 / $536.95	Professional		$257.93	$350.02	$536.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,216.90 / $5,000.00	Facility		$55.00	$1,216.90	$5,000.00
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $347.35 / $732.30 / $760.56	Facility	62	$347.35	$732.30	$760.56
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $55.58 / $117.17 / $121.69	Facility	AS	$55.58	$117.17	$121.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,780.96 / $1,822.88 / $2,244.60	Professional		$1,780.96	$1,822.88	$2,244.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $230.18 / $292.42 / $576.85	Facility		$230.18	$292.42	$576.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $279.01 / $369.02 / $465.67	Professional		$279.01	$369.02	$465.67
Moda Health Facility/Professional Professional Modifier AS Low / Median / High Price $16.39 / $36.74 / $121.88	Professional	AS	$16.39	$36.74	$121.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $266.33 / $405.33 / $890.88	Professional		$266.33	$405.33	$890.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $230.18 / $287.62 / $575.75	Facility		$230.18	$287.62	$575.75
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $179.42 / $179.42 / $381.93	Facility	62	$179.42	$179.42	$381.93
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $97.77 / $97.77 / $97.77	Facility	80	$97.77	$97.77	$97.77
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $28.71 / $28.71 / $83.11	Facility	AS	$28.71	$28.71	$83.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $262.48 / $358.72 / $546.27	Professional		$262.48	$358.72	$546.27
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $65.20 / $70.31 / $80.73	Professional	AS	$65.20	$70.31	$80.73
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 $208.04 / $284.95 / $458.39	Professional		$208.04	$284.95	$458.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.67 / $243.68 / $333.49	Professional		$213.67	$243.68	$333.49