Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,199.77 / $4,638.00 / $18,528.25	Facility		$1,199.77	$4,638.00	$18,528.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,261.68 / $1,463.26 / $2,505.83	Professional		$1,261.68	$1,463.26	$2,505.83
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $209.53 / $310.83 / $786.90	Professional	AS	$209.53	$310.83	$786.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $914.27 / $1,374.85 / $2,589.08	Professional		$914.27	$1,374.85	$2,589.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,496.32 / $2,578.13 / $32,396.20	Facility		$1,496.32	$2,578.13	$32,396.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,156.20 / $1,435.79 / $2,238.96	Professional		$1,156.20	$1,435.79	$2,238.96
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $515.36 / $1,275.89 / $26,861.96	Facility		$515.36	$1,275.89	$26,861.96
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $1,443.59 / $1,968.64 / $2,695.38	Professional		$1,443.59	$1,968.64	$2,695.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,270.34 / $16,067.67 / $16,067.67	Facility		$1,270.34	$16,067.67	$16,067.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,636.45 / $1,636.45 / $1,636.45	Facility		$1,636.45	$1,636.45	$1,636.45
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $161.91 / $161.91 / $161.91	Facility	AS	$161.91	$161.91	$161.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,468.58 / $1,934.92 / $3,024.96	Professional		$1,468.58	$1,934.92	$3,024.96
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $82,357.35	Facility		$55.00	$55.00	$82,357.35
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $325.52 / $7,806.31 / $7,806.31	Facility	AS	$325.52	$7,806.31	$7,806.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $10,391.76 / $10,613.28 / $12,346.43	Professional		$10,391.76	$10,613.28	$12,346.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,404.50 / $1,837.61 / $3,185.68	Facility		$1,404.50	$1,837.61	$3,185.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,627.07 / $2,122.26 / $2,631.60	Professional		$1,627.07	$2,122.26	$2,631.60
Moda Health Facility/Professional Professional Modifier AS Low / Median / High Price $92.10 / $92.10 / $159.94	Professional	AS	$92.10	$92.10	$159.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,533.58 / $2,333.09 / $2,948.18	Professional		$1,533.58	$2,333.09	$2,948.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,404.50 / $1,837.61 / $3,197.47	Facility		$1,404.50	$1,837.61	$3,197.47
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $550.28 / $550.28 / $550.28	Facility	80	$550.28	$550.28	$550.28
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $161.91 / $161.91 / $467.74	Facility	AS	$161.91	$161.91	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,478.09 / $2,012.98 / $3,073.05	Professional		$1,478.09	$2,012.98	$3,073.05
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $364.26 / $377.08 / $443.73	Professional	AS	$364.26	$377.08	$443.73
United Facility/Professional Facility Modifier Low / Median / High Price $4,738.00 / $9,458.00 / $27,388.00	Facility		$4,738.00	$9,458.00	$27,388.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,175.68 / $1,574.14 / $2,453.79	Professional		$1,175.68	$1,574.14	$2,453.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,207.52 / $1,374.85 / $1,902.62	Professional		$1,207.52	$1,374.85	$1,902.62