Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.00 / $2,128.00 / $7,513.00	Facility		$428.00	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $214.98 / $254.21 / $407.05	Facility	54	$214.98	$254.21	$407.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.83 / $351.82 / $615.10	Professional		$291.83	$351.82	$615.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $435.22 / $435.22 / $641.41	Professional		$435.22	$435.22	$641.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.41 / $346.75 / $802.18	Facility		$193.41	$346.75	$802.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.42 / $400.51 / $559.62	Professional		$316.42	$400.51	$559.62
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $328.93 / $526.29 / $713.48	Professional		$328.93	$526.29	$713.48
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $337.17 / $337.28	Facility		$80.00	$337.17	$337.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $578.13 / $578.13 / $578.13	Facility		$578.13	$578.13	$578.13
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $404.69 / $404.69 / $404.69	Facility	54	$404.69	$404.69	$404.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.35 / $447.84 / $687.42	Professional		$337.35	$447.84	$687.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,632.24 / $11,500.00 / $12,000.00	Facility		$1,632.24	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,120.06 / $1,265.30 / $1,265.30	Facility	54	$1,120.06	$1,265.30	$1,265.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,514.96 / $2,784.64 / $3,243.45	Professional		$2,514.96	$2,784.64	$3,243.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $312.61 / $401.58 / $640.28	Facility		$312.61	$401.58	$640.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $435.58 / $519.88 / $662.84	Professional		$435.58	$519.88	$662.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $408.68 / $528.61 / $856.08	Professional		$408.68	$528.61	$856.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $314.23 / $405.01 / $664.89	Facility		$314.23	$405.01	$664.89
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $404.69 / $404.69 / $699.58	Facility	54	$404.69	$404.69	$699.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $347.28 / $474.01 / $722.49	Professional		$347.28	$474.01	$722.49
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 $278.25 / $383.09 / $583.76	Professional		$278.25	$383.09	$583.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.93 / $356.74 / $501.61	Professional		$316.93	$356.74	$501.61