Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $589.00 / $2,315.00 / $7,542.00	Facility		$589.00	$2,315.00	$7,542.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $325.52 / $378.13 / $615.79	Facility	54	$325.52	$378.13	$615.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $476.29 / $556.29 / $908.97	Professional		$476.29	$556.29	$908.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $437.20 / $572.25 / $1,027.56	Professional		$437.20	$572.25	$1,027.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,111.42 / $2,127.96 / $4,594.77	Facility		$1,111.42	$2,127.96	$4,594.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $481.09 / $599.28 / $848.40	Professional		$481.09	$599.28	$848.40
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $499.27 / $960.00 / $8,100.00	Facility		$499.27	$960.00	$8,100.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $572.25 / $723.76 / $948.51	Professional		$572.25	$723.76	$948.51
Christus Facility/Professional Facility Modifier Low / Median / High Price $532.65 / $831.10 / $831.10	Facility		$532.65	$831.10	$831.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $879.98 / $879.98 / $879.98	Facility		$879.98	$879.98	$879.98
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $615.99 / $615.99 / $615.99	Facility	54	$615.99	$615.99	$615.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $530.15 / $696.45 / $1,075.76	Professional		$530.15	$696.45	$1,075.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,458.40 / $11,500.00 / $26,542.00	Facility		$2,458.40	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,688.06 / $1,874.67 / $1,874.67	Facility	54	$1,688.06	$1,874.67	$1,874.67
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,783.20 / $4,098.39 / $4,775.47	Professional		$3,783.20	$4,098.39	$4,775.47
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $502.20 / $663.95 / $1,078.34	Facility		$502.20	$663.95	$1,078.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $640.85 / $788.38 / $983.39	Professional		$640.85	$788.38	$983.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $614.58 / $949.48 / $2,007.92	Professional		$614.58	$949.48	$2,007.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $502.20 / $664.45 / $1,078.34	Facility		$502.20	$664.45	$1,078.34
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $615.99 / $615.99 / $1,042.61	Facility	54	$615.99	$615.99	$1,042.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $535.73 / $735.44 / $1,113.65	Professional		$535.73	$735.44	$1,113.65
United Facility/Professional Facility Modifier Low / Median / High Price $374.00 / $1,529.00 / $3,400.00	Facility		$374.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $442.22 / $582.13 / $924.95	Professional		$442.22	$582.13	$924.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $466.28 / $526.95 / $736.59	Professional		$466.28	$526.95	$736.59