Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $391.06 / $1,140.00 / $5,906.00	Facility		$391.06	$1,140.00	$5,906.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $209.63 / $238.06 / $396.64	Facility	54	$209.63	$238.06	$396.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.37 / $332.88 / $590.22	Professional		$247.37	$332.88	$590.22
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $209.63 / $251.60 / $411.17	Professional	54	$209.63	$251.60	$411.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $333.96 / $370.20 / $434.15	Professional		$333.96	$370.20	$434.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.88 / $169.98 / $666.84	Facility		$95.88	$169.98	$666.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.39 / $378.39 / $537.54	Professional		$305.39	$378.39	$537.54
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $225.24 / $281.55 / $865.11	Facility		$225.24	$281.55	$865.11
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $339.36 / $451.32 / $584.42	Professional		$339.36	$451.32	$584.42
Christus Facility/Professional Facility Modifier Low / Median / High Price $208.94 / $208.94 / $329.99	Facility		$208.94	$208.94	$329.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $560.70 / $560.70 / $560.70	Facility		$560.70	$560.70	$560.70
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $392.49	Facility	54	$392.49	$392.49	$392.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.30 / $411.68 / $641.03	Professional		$313.30	$411.68	$641.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,788.33	Facility		$55.00	$55.00	$1,788.33
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,094.65 / $1,251.83 / $1,251.83	Facility	54	$1,094.65	$1,251.83	$1,251.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,459.67 / $2,607.36 / $3,042.60	Professional		$2,459.67	$2,607.36	$3,042.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $283.87 / $365.04 / $600.37	Facility		$283.87	$365.04	$600.37
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $417.68 / $501.21 / $621.50	Professional		$417.68	$501.21	$621.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $388.88 / $600.74 / $1,279.07	Professional		$388.88	$600.74	$1,279.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $283.68 / $365.53 / $624.86	Facility		$283.68	$365.53	$624.86
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $654.61	Facility	54	$392.49	$392.49	$654.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $323.20 / $433.00 / $674.78	Professional		$323.20	$433.00	$674.78
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $497.38 / $523.04 / $635.86	Professional	54	$497.38	$523.04	$635.86
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 $254.34 / $343.21 / $531.98	Professional		$254.34	$343.21	$531.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $297.32 / $333.96 / $471.02	Professional		$297.32	$333.96	$471.02