Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $1,905.46 / $6,918.31	Facility		$457.09	$1,905.46	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $407.38 / $741.31	Professional		$281.84	$407.38	$741.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,047.13 / $1,047.13 / $1,380.38	Professional	50	$1,047.13	$1,047.13	$1,380.38
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $281.84 / $436.52 / $707.95	Professional	54	$281.84	$436.52	$707.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $363.08 / $575.44	Professional		$213.80	$363.08	$575.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $169.82 / $741.31	Facility		$100.00	$169.82	$741.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $398.11 / $537.03	Professional		$309.03	$398.11	$537.03
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $269.15 / $354.81	Facility		$223.87	$269.15	$354.81
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $426.58 / $616.60	Professional		$218.78	$426.58	$616.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $331.13	Facility		$223.87	$223.87	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $416.87 / $660.69	Professional		$316.23	$416.87	$660.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $4,786.30	Facility		$54.95	$56.23	$4,786.30
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility	54	$1,445.44	$1,445.44	$1,445.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,019.95 / $3,019.95	Professional		$2,570.40	$3,019.95	$3,019.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $436.52 / $1,905.46	Facility		$295.12	$436.52	$1,905.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $436.52 / $707.95	Professional		$288.40	$436.52	$707.95
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,047.13 / $1,047.13 / $1,380.38	Professional	50	$1,047.13	$1,047.13	$1,380.38
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $288.40 / $398.11 / $537.03	Professional	54	$288.40	$398.11	$537.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $269.15 / $323.59	Professional		$32.36	$269.15	$323.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $1,258.93 / $1,412.54	Professional		$331.13	$1,258.93	$1,412.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $398.11 / $691.83	Facility		$288.40	$398.11	$691.83
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $389.05 / $389.05 / $389.05	Facility	54	$389.05	$389.05	$389.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $691.83	Professional		$302.00	$426.58	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $1,047.13 / $2,691.53	Facility		$162.18	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $501.19	Professional		$245.47	$323.59	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $389.05 / $389.05	Professional		$371.54	$389.05	$389.05