Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $324.92 / $1,922.00 / $6,762.00	Facility		$324.92	$1,922.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $158.30 / $185.27 / $302.57	Facility	54	$158.30	$185.27	$302.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.47 / $258.80 / $460.16	Professional		$215.47	$258.80	$460.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $240.04 / $345.75 / $523.55	Professional		$240.04	$345.75	$523.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.16 / $167.03 / $666.84	Facility		$95.16	$167.03	$666.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.31 / $295.32 / $411.44	Professional		$233.31	$295.32	$411.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $280.08 / $378.64 / $471.47	Professional		$280.08	$378.64	$471.47
Christus Facility/Professional Facility Modifier Low / Median / High Price $185.18 / $185.18 / $249.72	Facility		$185.18	$185.18	$249.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $428.72 / $428.72 / $428.72	Facility		$428.72	$428.72	$428.72
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $300.10 / $300.10 / $300.10	Facility	54	$300.10	$300.10	$300.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.66 / $328.81 / $505.71	Professional		$247.66	$328.81	$505.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,352.66	Facility		$55.00	$55.00	$1,352.66
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $833.97 / $946.86 / $946.86	Facility	54	$833.97	$946.86	$946.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,870.00 / $2,035.92 / $2,387.85	Professional		$1,870.00	$2,035.92	$2,387.85
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $232.50 / $298.29 / $467.67	Facility		$232.50	$298.29	$467.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $318.20 / $382.20 / $487.31	Professional		$318.20	$382.20	$487.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $304.10 / $382.98 / $623.13	Professional		$304.10	$382.98	$623.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $232.50 / $300.52 / $490.14	Facility		$232.50	$300.52	$490.14
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $300.10 / $300.10 / $509.42	Facility	54	$300.10	$300.10	$509.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $255.36 / $346.92 / $530.65	Professional		$255.36	$346.92	$530.65
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $943.00 / $2,376.00	Facility		$161.00	$943.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $203.27 / $277.58 / $425.65	Professional		$203.27	$277.58	$425.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $233.00 / $261.93 / $368.82	Professional		$233.00	$261.93	$368.82