Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $276.04 / $1,276.00 / $5,216.00	Facility		$276.04	$1,276.00	$5,216.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $125.81 / $152.91 / $271.02	Facility	52	$125.81	$152.91	$271.02
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $188.72 / $229.36 / $367.19	Facility	54	$188.72	$229.36	$367.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.62 / $311.69 / $517.19	Professional		$251.62	$311.69	$517.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $342.71 / $342.71 / $675.04	Professional		$342.71	$342.71	$675.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.29 / $345.02 / $769.83	Facility		$191.29	$345.02	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $283.48 / $358.82 / $504.22	Professional		$283.48	$358.82	$504.22
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $82.90 / $143.19 / $2,238.10	Facility		$82.90	$143.19	$2,238.10
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $296.72 / $460.80 / $657.02	Professional		$296.72	$460.80	$657.02
Christus Facility/Professional Facility Modifier Low / Median / High Price $222.21 / $222.21 / $355.35	Facility		$222.21	$222.21	$355.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $523.77 / $523.77 / $523.77	Facility		$523.77	$523.77	$523.77
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $419.02 / $419.02 / $419.02	Facility	52	$419.02	$419.02	$419.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $366.64 / $366.64 / $366.64	Facility	54	$366.64	$366.64	$366.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.04 / $396.51 / $612.24	Professional		$300.04	$396.51	$612.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,439.66 / $11,500.00 / $12,000.00	Facility		$1,439.66	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,151.73 / $1,285.16 / $1,285.16	Facility	52	$1,151.73	$1,285.16	$1,285.16
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,007.76 / $1,124.51 / $1,124.51	Facility	54	$1,007.76	$1,124.51	$1,124.51
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,258.80 / $2,546.80 / $2,983.35	Professional		$2,258.80	$2,546.80	$2,983.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $279.62 / $360.35 / $579.75	Facility		$279.62	$360.35	$579.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $392.22 / $477.76 / $609.15	Professional		$392.22	$477.76	$609.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $392.66 / $623.58 / $1,299.52	Professional		$392.66	$623.58	$1,299.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $279.62 / $361.96 / $594.69	Facility		$279.62	$361.96	$594.69
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $419.02 / $419.02 / $419.02	Facility	52	$419.02	$419.02	$419.02
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $366.64 / $366.64 / $632.12	Facility	54	$366.64	$366.64	$632.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $307.19 / $416.45 / $644.09	Professional		$307.19	$416.45	$644.09
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 $246.96 / $331.30 / $512.85	Professional		$246.96	$331.30	$512.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $291.26 / $328.51 / $460.44	Professional		$291.26	$328.51	$460.44