Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $326.43 / $2,295.00 / $7,078.00	Facility		$326.43	$2,295.00	$7,078.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $192.08 / $233.00 / $362.36	Facility	54	$192.08	$233.00	$362.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.07 / $314.83 / $534.51	Professional		$266.07	$314.83	$534.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $666.16 / $666.16 / $666.16	Professional		$666.16	$666.16	$666.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $206.30 / $310.52 / $741.41	Facility		$206.30	$310.52	$741.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.25 / $357.26 / $510.93	Professional		$282.25	$357.26	$510.93
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $206.29 / $281.55 / $985.83	Facility		$206.29	$281.55	$985.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $288.44 / $288.44 / $301.95	Facility		$288.44	$288.44	$301.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $514.65 / $514.65 / $514.65	Facility		$514.65	$514.65	$514.65
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $360.25 / $360.25 / $360.25	Facility	54	$360.25	$360.25	$360.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $306.12 / $403.25 / $622.85	Professional		$306.12	$403.25	$622.85
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,450.88 / $11,500.00 / $16,394.00	Facility		$1,450.88	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $997.15 / $1,126.33 / $1,126.33	Facility	54	$997.15	$1,126.33	$1,126.33
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,238.40 / $2,533.04 / $2,947.43	Professional		$2,238.40	$2,533.04	$2,947.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $285.58 / $372.60 / $588.19	Facility		$285.58	$372.60	$588.19
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $388.08 / $472.32 / $602.21	Professional		$388.08	$472.32	$602.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $360.17 / $526.04 / $777.29	Professional		$360.17	$526.04	$777.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $285.58 / $372.66 / $605.19	Facility		$285.58	$372.66	$605.19
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $360.25 / $360.25 / $641.11	Facility	54	$360.25	$360.25	$641.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $313.89 / $428.51 / $656.61	Professional		$313.89	$428.51	$656.61
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 $252.54 / $341.10 / $531.36	Professional		$252.54	$341.10	$531.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $287.94 / $324.00 / $455.76	Professional		$287.94	$324.00	$455.76