Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $7,943.28 / $19,952.62	Facility		$1,445.44	$7,943.28	$19,952.62
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $10,471.29 / $16,218.10 / $19,054.61	Facility	22	$10,471.29	$16,218.10	$19,054.61
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,309.57 / $17,378.01 / $39,810.72	Facility	50	$6,309.57	$17,378.01	$39,810.72
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	AS	$2,511.89	$2,511.89	$2,511.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,621.81 / $5,128.61	Professional		$831.76	$1,621.81	$5,128.61
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $162.18 / $309.03 / $831.76	Professional	AS	$162.18	$309.03	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $1,202.26 / $1,698.24	Professional		$165.96	$1,202.26	$1,698.24
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $181.97 / $223.87 / $354.81	Professional	AS	$181.97	$223.87	$354.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $16,982.44 / $40,738.03	Facility		$3,890.45	$16,982.44	$40,738.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,230.27 / $1,905.46	Professional		$1,000.00	$1,230.27	$1,905.46
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,258.93 / $12,589.25	Facility		$512.86	$1,258.93	$12,589.25
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $1,122.02 / $2,041.74	Professional		$676.08	$1,122.02	$2,041.74
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $11,481.54 / $11,481.54	Facility		$1,122.02	$11,481.54	$11,481.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,862.09 / $3,235.94	Professional		$1,288.25	$1,862.09	$3,235.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $19,054.61 / $33,884.42 / $52,480.75	Facility		$19,054.61	$33,884.42	$52,480.75
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $37,153.52 / $37,153.52 / $37,153.52	Facility	54	$37,153.52	$37,153.52	$37,153.52
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $5,248.07 / $5,248.07 / $5,248.07	Facility	AS	$5,248.07	$5,248.07	$5,248.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,220.18 / $11,220.18 / $11,220.18	Professional		$11,220.18	$11,220.18	$11,220.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,884.03 / $15,135.61	Facility		$1,202.26	$2,884.03	$15,135.61
Moda Health Facility/Professional Facility Modifier 22 Low / Median / High Price $10,471.29 / $16,218.10 / $19,054.61	Facility	22	$10,471.29	$16,218.10	$19,054.61
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $4,168.69 / $17,378.01 / $46,773.51	Facility	50	$4,168.69	$17,378.01	$46,773.51
Moda Health Facility/Professional Facility Modifier AS Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	AS	$2,511.89	$2,511.89	$2,511.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $3,090.30	Professional		$1,148.15	$1,548.82	$3,090.30
Moda Health Facility/Professional Professional Modifier AS Low / Median / High Price $158.49 / $281.84 / $741.31	Professional	AS	$158.49	$281.84	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $162.18 / $1,096.48	Professional		$32.36	$162.18	$1,096.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $4,168.69 / $4,265.80	Professional		$1,995.26	$4,168.69	$4,265.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,862.09 / $3,162.28	Facility		$1,202.26	$1,862.09	$3,162.28
Providence Facility/Professional Facility Modifier 22 Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility	22	$2,630.27	$2,630.27	$2,630.27
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	54	$1,513.56	$1,513.56	$1,513.56
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	AS	$218.78	$218.78	$218.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,819.70 / $2,951.21	Professional		$1,258.93	$1,819.70	$2,951.21
United Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $11,748.98 / $28,840.32	Facility		$4,677.35	$11,748.98	$28,840.32
United Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,479.11 / $2,344.23	Professional		$1,122.02	$1,479.11	$2,344.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,202.26 / $1,202.26	Professional		$1,122.02	$1,202.26	$1,202.26