Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $689.00 / $2,816.00 / $7,542.00	Facility		$689.00	$2,816.00	$7,542.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $245.98 / $270.80 / $447.62	Facility	52	$245.98	$270.80	$447.62
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $368.96 / $406.20 / $671.42	Facility	54	$368.96	$406.20	$671.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,233.40 / $2,155.07 / $4,716.76	Facility		$1,233.40	$2,155.07	$4,716.76
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $568.55 / $1,561.90 / $4,500.00	Facility		$568.55	$1,561.90	$4,500.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $542.48 / $1,984.11 / $1,984.11	Facility		$542.48	$1,984.11	$1,984.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $664.73 / $664.73 / $664.73	Facility		$664.73	$664.73	$664.73
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $530.59 / $530.59 / $530.59	Facility	52	$530.59	$530.59	$530.59
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $464.27 / $464.27 / $464.27	Facility	54	$464.27	$464.27	$464.27
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,743.45 / $11,500.00 / $16,394.00	Facility		$2,743.45	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,068.68 / $3,605.48 / $3,605.48	Facility	52	$1,068.68	$3,605.48	$3,605.48
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $935.09 / $3,154.80 / $3,154.80	Facility	54	$935.09	$3,154.80	$3,154.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $563.95 / $711.34 / $1,095.19	Facility		$563.95	$711.34	$1,095.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $566.84 / $715.50 / $1,165.69	Facility		$566.84	$715.50	$1,165.69
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $530.59 / $530.59 / $530.59	Facility	52	$530.59	$530.59	$530.59
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $464.27 / $464.27 / $1,121.63	Facility	54	$464.27	$464.27	$1,121.63
United Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $2,064.00 / $4,509.00	Facility		$600.00	$2,064.00	$4,509.00