Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $2,089.30 / $6,918.31	Facility		$467.74	$2,089.30	$6,918.31
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Facility	22	$3,548.13	$3,548.13	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $446.68 / $1,548.82	Professional		$234.42	$446.68	$1,548.82
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $29.51 / $69.18 / $218.78	Professional	AS	$29.51	$69.18	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $281.84 / $380.19	Professional		$223.87	$281.84	$380.19
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $28.84 / $39.81 / $64.57	Professional	AS	$28.84	$39.81	$64.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $4,365.16 / $19,054.61	Facility		$1,023.29	$4,365.16	$19,054.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $380.19	Professional		$208.93	$245.47	$380.19
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,258.93 / $7,943.28	Facility		$512.86	$1,258.93	$7,943.28
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $338.84 / $436.52	Professional		$245.47	$338.84	$436.52
Christus Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $239.88 / $239.88	Facility		$223.87	$239.88	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $354.81 / $562.34	Professional		$257.04	$354.81	$562.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $5,011.87 / $5,011.87	Facility		$1,548.82	$5,011.87	$5,011.87
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	62	$977.24	$977.24	$977.24
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	AS	$154.88	$154.88	$154.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,238.72 / $2,238.72	Professional		$1,778.28	$2,238.72	$2,238.72
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $1,288.25 / $6,025.60	Facility		$275.42	$1,288.25	$6,025.60
Moda Health Facility/Professional Facility Modifier 22 Low / Median / High Price $3,548.13 / $3,548.13 / $3,548.13	Facility	22	$3,548.13	$3,548.13	$3,548.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $331.13 / $851.14	Professional		$229.09	$331.13	$851.14
Moda Health Facility/Professional Professional Modifier AS Low / Median / High Price $20.89 / $61.66 / $151.36	Professional	AS	$20.89	$61.66	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $218.78	Professional		$32.36	$33.11	$218.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $812.83 / $831.76	Professional		$295.12	$812.83	$831.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $302.00 / $575.44	Facility		$229.09	$302.00	$575.44
Providence Facility/Professional Facility Modifier 22 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	22	$524.81	$524.81	$524.81
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $275.42 / $275.42 / $275.42	Facility	62	$275.42	$275.42	$275.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $43.65 / $43.65 / $43.65	Facility	AS	$43.65	$43.65	$43.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $346.74 / $549.54	Professional		$245.47	$346.74	$549.54
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,047.13 / $2,691.53	Facility		$158.49	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $446.68	Professional		$218.78	$288.40	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $245.47 / $245.47	Professional		$218.78	$245.47	$245.47