Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $461.42 / $2,128.00 / $7,513.00	Facility		$461.42	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.06 / $272.66 / $455.20	Facility	54	$245.06	$272.66	$455.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.39 / $398.36 / $673.54	Professional		$351.39	$398.36	$673.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $451.54 / $459.06 / $534.88	Professional		$451.54	$459.06	$534.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $219.95 / $362.28 / $704.87	Facility		$219.95	$362.28	$704.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $359.81 / $450.42 / $631.77	Professional		$359.81	$450.42	$631.77
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $376.28 / $602.04 / $758.66	Professional		$376.28	$602.04	$758.66
Christus Facility/Professional Facility Modifier Low / Median / High Price $203.79 / $203.79 / $366.47	Facility		$203.79	$203.79	$366.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $665.91 / $665.91 / $665.91	Facility		$665.91	$665.91	$665.91
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $466.14 / $466.14 / $466.14	Facility	54	$466.14	$466.14	$466.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $387.21 / $511.93 / $793.36	Professional		$387.21	$511.93	$793.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,272.60 / $11,500.00 / $12,000.00	Facility		$2,272.60	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,275.83 / $1,414.06 / $1,414.06	Facility	54	$1,275.83	$1,414.06	$1,414.06
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,859.28 / $2,941.28 / $3,432.23	Professional		$2,859.28	$2,941.28	$3,432.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $360.80 / $475.54 / $720.37	Facility		$360.80	$475.54	$720.37
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $486.81 / $584.17 / $724.38	Professional		$486.81	$584.17	$724.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $439.32 / $662.30 / $891.00	Professional		$439.32	$662.30	$891.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $361.65 / $483.68 / $761.20	Facility		$361.65	$483.68	$761.20
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $466.14 / $466.14 / $752.25	Facility	54	$466.14	$466.14	$752.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $397.68 / $530.99 / $811.65	Professional		$397.68	$530.99	$811.65
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 $302.88 / $410.74 / $635.30	Professional		$302.88	$410.74	$635.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $335.15 / $379.33 / $529.12	Professional		$335.15	$379.33	$529.12