Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $2,124.00 / $7,316.00	Facility		$425.00	$2,124.00	$7,316.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $193.85 / $228.77 / $366.92	Facility	54	$193.85	$228.77	$366.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.30 / $311.27 / $530.74	Professional		$266.30	$311.27	$530.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.94 / $296.50 / $391.19	Professional		$182.94	$296.50	$391.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.92 / $345.02 / $769.83	Facility		$191.92	$345.02	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $285.33 / $361.16 / $503.41	Professional		$285.33	$361.16	$503.41
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $326.14 / $428.75 / $533.70	Professional		$326.14	$428.75	$533.70
Christus Facility/Professional Facility Modifier Low / Median / High Price $241.83 / $241.83 / $300.70	Facility		$241.83	$241.83	$300.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.98 / $520.98 / $520.98	Facility		$520.98	$520.98	$520.98
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $364.69	Facility	54	$364.69	$364.69	$364.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.26 / $406.31 / $620.91	Professional		$305.26	$406.31	$620.91
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,467.84 / $11,500.00 / $12,000.00	Facility		$1,467.84	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,009.86 / $1,141.60 / $1,141.60	Facility	54	$1,009.86	$1,141.60	$1,141.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,267.28 / $2,500.16 / $2,916.08	Professional		$2,267.28	$2,500.16	$2,916.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $285.63 / $368.58 / $583.55	Facility		$285.63	$368.58	$583.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $391.57 / $467.35 / $595.87	Professional		$391.57	$467.35	$595.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $381.68 / $601.62 / $1,221.01	Professional		$381.68	$601.62	$1,221.01
Providence Facility/Professional Facility Modifier Low / Median / High Price $285.94 / $370.61 / $601.62	Facility		$285.94	$370.61	$601.62
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $629.54	Facility	54	$364.69	$364.69	$629.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $314.24 / $427.50 / $653.50	Professional		$314.24	$427.50	$653.50
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 $250.37 / $343.79 / $530.64	Professional		$250.37	$343.79	$530.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $284.91 / $320.64 / $450.93	Professional		$284.91	$320.64	$450.93