Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.80 / $2,017.00 / $6,386.00	Facility		$313.80	$2,017.00	$6,386.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $143.38 / $159.44 / $272.29	Facility	54	$143.38	$159.44	$272.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.17 / $227.91 / $397.13	Professional		$191.17	$227.91	$397.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.46 / $236.09 / $292.66	Professional		$113.46	$236.09	$292.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.28 / $345.02 / $769.83	Facility		$190.28	$345.02	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.78 / $266.63 / $366.32	Professional		$211.78	$266.63	$366.32
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $243.88 / $319.55 / $389.30	Professional		$243.88	$319.55	$389.30
Christus Facility/Professional Facility Modifier Low / Median / High Price $198.94 / $198.94 / $237.12	Facility		$198.94	$198.94	$237.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.22 / $265.22 / $265.22	Facility		$265.22	$265.22	$265.22
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $183.20	Facility	54	$183.20	$183.20	$183.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.36 / $289.55 / $453.71	Professional		$224.36	$289.55	$453.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,309.26 / $11,500.00 / $12,000.00	Facility		$1,309.26	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $376.47 / $755.54 / $853.99	Facility	54	$376.47	$755.54	$853.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,692.56 / $1,733.12 / $2,066.69	Professional		$1,692.56	$1,733.12	$2,066.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $204.22 / $260.70 / $408.06	Facility		$204.22	$260.70	$408.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $281.20 / $345.95 / $428.97	Professional		$281.20	$345.95	$428.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $276.66 / $439.89 / $900.55	Professional		$276.66	$439.89	$900.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.77 / $262.11 / $423.44	Facility		$204.77	$262.11	$423.44
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $429.77	Facility	54	$183.20	$183.20	$429.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $226.91 / $303.00 / $463.87	Professional		$226.91	$303.00	$463.87
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 $171.07 / $228.09 / $356.32	Professional		$171.07	$228.09	$356.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $196.84 / $221.71 / $311.24	Professional		$196.84	$221.71	$311.24