Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.70 / $3,445.00 / $10,893.00	Facility		$309.70	$3,445.00	$10,893.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $196.83 / $232.28 / $373.38	Facility	54	$196.83	$232.28	$373.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.04 / $320.36 / $535.16	Professional		$269.04	$320.36	$535.16
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 $291.18 / $368.56 / $513.49	Professional		$291.18	$368.56	$513.49
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $74.14 / $125.00 / $2,413.35	Facility		$74.14	$125.00	$2,413.35
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $179.52 / $179.52 / $314.11	Professional		$179.52	$179.52	$314.11
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $314.33 / $314.57	Facility		$80.00	$314.33	$314.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $530.78 / $530.78 / $530.78	Facility		$530.78	$530.78	$530.78
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $371.55 / $371.55 / $371.55	Facility	54	$371.55	$371.55	$371.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.54 / $409.78 / $629.79	Professional		$307.54	$409.78	$629.79
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,653.43	Facility		$55.00	$55.00	$1,653.43
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,026.83 / $1,157.40 / $1,157.40	Facility	54	$1,026.83	$1,157.40	$1,157.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,305.84 / $2,532.56 / $2,946.08	Professional		$2,305.84	$2,532.56	$2,946.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $295.64 / $372.99 / $653.54	Facility		$295.64	$372.99	$653.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $391.80 / $472.32 / $602.21	Professional		$391.80	$472.32	$602.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $340.56 / $545.74 / $1,194.77	Professional		$340.56	$545.74	$1,194.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $295.68 / $378.49 / $659.77	Facility		$295.68	$378.49	$659.77
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $371.55 / $371.55 / $639.17	Facility	54	$371.55	$371.55	$639.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $318.51 / $431.77 / $659.19	Professional		$318.51	$431.77	$659.19
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 $253.78 / $347.34 / $533.16	Professional		$253.78	$347.34	$533.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $287.94 / $324.33 / $455.63	Professional		$287.94	$324.33	$455.63