Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $2,454.71 / $7,943.28	Facility		$316.23	$2,454.71	$7,943.28
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	54	$177.83	$177.83	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $645.65	Professional		$257.04	$338.84	$645.65
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $295.12 / $398.11 / $602.56	Professional	54	$295.12	$398.11	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $338.84 / $389.05	Professional		$269.15	$338.84	$389.05
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $346.74 / $346.74 / $602.56	Professional	54	$346.74	$346.74	$602.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $169.82 / $741.31	Facility		$97.72	$169.82	$741.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $478.63	Professional		$275.42	$346.74	$478.63
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $229.09 / $354.81	Facility		$204.17	$229.09	$354.81
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $416.87 / $588.84	Professional		$309.03	$416.87	$588.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $288.40	Facility		$208.93	$208.93	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $602.56	Professional		$281.84	$380.19	$602.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $3,467.37	Facility		$54.95	$56.23	$3,467.37
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility	54	$1,288.25	$1,288.25	$1,288.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,691.53 / $2,691.53	Professional		$2,290.87	$2,691.53	$2,691.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $371.54 / $977.24	Facility		$257.04	$371.54	$977.24
Moda Health Facility/Professional Facility Modifier 54 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	54	$177.83	$177.83	$177.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $389.05 / $630.96	Professional		$257.04	$389.05	$630.96
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $309.03 / $398.11 / $724.44	Professional	54	$309.03	$398.11	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $234.42 / $288.40	Professional		$32.36	$234.42	$288.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $575.44	Professional		$269.15	$269.15	$575.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $354.81 / $602.56	Facility		$245.47	$354.81	$602.56
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	54	$346.74	$346.74	$346.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $380.19 / $602.56	Professional		$269.15	$380.19	$602.56
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 $223.87 / $295.12 / $446.68	Professional		$223.87	$295.12	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $346.74 / $346.74	Professional		$323.59	$346.74	$346.74