Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $488.00 / $2,128.00 / $7,316.00	Facility		$488.00	$2,128.00	$7,316.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $303.63 / $363.56 / $574.66	Facility	54	$303.63	$363.56	$574.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $435.74 / $509.79 / $833.73	Professional		$435.74	$509.79	$833.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.60 / $360.12 / $810.81	Facility		$210.60	$360.12	$810.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $452.34 / $570.17 / $819.44	Professional		$452.34	$570.17	$819.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $453.93 / $467.02 / $684.77	Professional		$453.93	$467.02	$684.77
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $452.22 / $458.48	Facility		$80.00	$452.22	$458.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $823.44 / $823.44 / $823.44	Facility		$823.44	$823.44	$823.44
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $576.41 / $576.41 / $576.41	Facility	54	$576.41	$576.41	$576.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $497.59 / $663.46 / $1,008.57	Professional		$497.59	$663.46	$1,008.57
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,799.60 / $11,500.00 / $12,000.00	Facility		$2,799.60	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,572.54 / $1,733.89 / $1,733.89	Facility	54	$1,572.54	$1,733.89	$1,733.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,524.16 / $3,926.40 / $4,573.43	Professional		$3,524.16	$3,926.40	$4,573.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $477.78 / $617.08 / $975.74	Facility		$477.78	$617.08	$975.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $612.03 / $732.72 / $934.22	Professional		$612.03	$732.72	$934.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $591.54 / $932.12 / $1,892.67	Professional		$591.54	$932.12	$1,892.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $477.78 / $618.41 / $995.96	Facility		$477.78	$618.41	$995.96
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $576.41 / $576.41 / $1,002.78	Facility	54	$576.41	$576.41	$1,002.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $500.38 / $692.82 / $1,040.41	Professional		$500.38	$692.82	$1,040.41
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 $406.01 / $557.61 / $873.18	Professional		$406.01	$557.61	$873.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $505.34 / $705.38	Professional		$446.68	$505.34	$705.38