Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $256.99 / $1,839.00 / $6,691.00	Facility		$256.99	$1,839.00	$6,691.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $121.47 / $140.60 / $232.58	Facility	54	$121.47	$140.60	$232.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.97 / $196.43 / $351.45	Professional		$163.97	$196.43	$351.45
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $129.43 / $149.47 / $247.33	Professional	54	$129.43	$149.47	$247.33
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $217.07 / $217.07 / $217.07	Professional	54	$217.07	$217.07	$217.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.71 / $163.44 / $647.07	Facility		$93.71	$163.44	$647.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.45 / $224.86 / $316.45	Professional		$179.45	$224.86	$316.45
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $206.29 / $281.55 / $528.98	Facility		$206.29	$281.55	$528.98
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $209.85 / $291.94 / $399.72	Professional		$209.85	$291.94	$399.72
Christus Facility/Professional Facility Modifier Low / Median / High Price $197.98 / $218.20 / $218.20	Facility		$197.98	$218.20	$218.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.43 / $329.43 / $329.43	Facility		$329.43	$329.43	$329.43
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.60 / $230.60 / $230.60	Facility	54	$230.60	$230.60	$230.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.49 / $248.21 / $385.07	Professional		$189.49	$248.21	$385.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,041.68	Facility		$55.00	$55.00	$1,041.68
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $641.12 / $729.18 / $729.18	Facility	54	$641.12	$729.18	$729.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,439.44 / $1,554.96 / $1,820.18	Professional		$1,439.44	$1,554.96	$1,820.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $175.11 / $225.53 / $354.21	Facility		$175.11	$225.53	$354.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $244.35 / $291.63 / $371.83	Professional		$244.35	$291.63	$371.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $228.39 / $334.75 / $485.13	Professional		$228.39	$334.75	$485.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $175.11 / $228.01 / $374.12	Facility		$175.11	$228.01	$374.12
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $230.60 / $230.60 / $386.73	Facility	54	$230.60	$230.60	$386.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $196.03 / $261.68 / $403.31	Professional		$196.03	$261.68	$403.31
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $299.89 / $311.30 / $375.65	Professional	54	$299.89	$311.30	$375.65
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 $154.69 / $211.02 / $321.95	Professional		$154.69	$211.02	$321.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.79 / $199.86 / $281.52	Professional		$177.79	$199.86	$281.52