Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $423.07 / $2,000.00 / $6,762.00	Facility		$423.07	$2,000.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $172.61 / $205.88 / $327.22	Facility	54	$172.61	$205.88	$327.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.65 / $280.08 / $473.78	Professional		$236.65	$280.08	$473.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $264.42 / $264.42 / $264.42	Professional		$264.42	$264.42	$264.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $189.76 / $345.02 / $769.83	Facility		$189.76	$345.02	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $254.24 / $321.81 / $464.50	Professional		$254.24	$321.81	$464.50
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $301.05 / $400.91 / $508.84	Professional		$301.05	$400.91	$508.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $208.94 / $208.94 / $272.51	Facility		$208.94	$208.94	$272.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $464.51 / $464.51 / $464.51	Facility		$464.51	$464.51	$464.51
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $325.16	Facility	54	$325.16	$325.16	$325.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.41 / $362.52 / $554.90	Professional		$272.41	$362.52	$554.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,309.00 / $11,500.00 / $12,000.00	Facility		$1,309.00	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $900.74 / $1,018.85 / $1,018.85	Facility	54	$900.74	$1,018.85	$1,018.85
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,022.32 / $2,250.64 / $2,627.78	Professional		$2,022.32	$2,250.64	$2,627.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $252.25 / $328.60 / $523.04	Facility		$252.25	$328.60	$523.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $350.56 / $421.15 / $536.96	Professional		$350.56	$421.15	$536.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $328.66 / $428.18 / $693.88	Professional		$328.66	$428.18	$693.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $252.38 / $330.19 / $539.67	Facility		$252.38	$330.19	$539.67
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $566.60	Facility	54	$325.16	$325.16	$566.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $282.79 / $383.68 / $582.51	Professional		$282.79	$383.68	$582.51
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 $226.28 / $311.14 / $476.62	Professional		$226.28	$311.14	$476.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $256.74 / $288.87 / $406.42	Professional		$256.74	$288.87	$406.42