Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.96 / $1,871.00 / $8,883.00	Facility		$183.96	$1,871.00	$8,883.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $120.80 / $132.38 / $227.45	Facility	54	$120.80	$132.38	$227.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.07 / $188.32 / $331.30	Professional		$161.07	$188.32	$331.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.25 / $150.25 / $391.39	Professional		$150.25	$150.25	$391.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $166.71 / $666.84	Facility		$94.80	$166.71	$666.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.61 / $219.91 / $308.45	Professional		$177.61	$219.91	$308.45
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $189.54 / $275.07 / $374.80	Professional		$189.54	$275.07	$374.80
Christus Facility/Professional Facility Modifier Low / Median / High Price $201.54 / $224.51 / $224.51	Facility		$201.54	$224.51	$224.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.31 / $224.31 / $224.31	Facility		$224.31	$224.31	$224.31
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $154.76 / $154.76 / $154.76	Facility	54	$154.76	$154.76	$154.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.49 / $241.74 / $379.07	Professional		$183.49	$241.74	$379.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $3,930.50	Facility		$55.00	$55.00	$3,930.50
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $319.56 / $638.98 / $725.42	Facility	54	$319.56	$638.98	$725.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,434.32 / $1,452.64 / $1,724.18	Professional		$1,434.32	$1,452.64	$1,724.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $168.90 / $217.20 / $343.98	Facility		$168.90	$217.20	$343.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $228.79 / $281.76 / $362.79	Professional		$228.79	$281.76	$362.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $222.21 / $325.82 / $455.10	Professional		$222.21	$325.82	$455.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $168.66 / $217.97 / $354.80	Facility		$168.66	$217.97	$354.80
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $154.76 / $154.76 / $361.67	Facility	54	$154.76	$154.76	$361.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $189.54 / $253.75 / $388.90	Professional		$189.54	$253.75	$388.90
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 $144.00 / $192.00 / $299.47	Professional		$144.00	$192.00	$299.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $166.47 / $187.40 / $263.43	Professional		$166.47	$187.40	$263.43