Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $388.44 / $1,904.00 / $6,691.00	Facility		$388.44	$1,904.00	$6,691.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $207.35 / $243.89 / $392.21	Facility	54	$207.35	$243.89	$392.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.17 / $335.29 / $577.42	Professional		$288.17	$335.29	$577.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $366.07 / $366.07 / $366.07	Professional		$366.07	$366.07	$366.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.41 / $347.18 / $790.83	Facility		$193.41	$347.18	$790.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.33 / $384.95 / $538.46	Professional		$305.33	$384.95	$538.46
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $375.53 / $495.02 / $600.12	Professional		$375.53	$495.02	$600.12
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $322.82 / $323.14	Facility		$80.00	$322.82	$323.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $557.42 / $557.42 / $557.42	Facility		$557.42	$557.42	$557.42
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $390.20 / $390.20 / $390.20	Facility	54	$390.20	$390.20	$390.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $329.43 / $439.16 / $666.52	Professional		$329.43	$439.16	$666.52
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,573.16 / $11,500.00 / $12,000.00	Facility		$1,573.16	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,078.76 / $1,216.95 / $1,216.95	Facility	54	$1,078.76	$1,216.95	$1,216.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,423.36 / $2,663.36 / $3,100.58	Professional		$2,423.36	$2,663.36	$3,100.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $317.58 / $401.24 / $628.23	Facility		$317.58	$401.24	$628.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $416.60 / $497.22 / $633.96	Professional		$416.60	$497.22	$633.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $391.01 / $618.87 / $1,272.35	Professional		$391.01	$618.87	$1,272.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $317.58 / $401.90 / $645.74	Facility		$317.58	$401.90	$645.74
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $390.20 / $390.20 / $671.30	Facility	54	$390.20	$390.20	$671.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $340.01 / $459.23 / $703.52	Professional		$340.01	$459.23	$703.52
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 $268.24 / $357.65 / $565.41	Professional		$268.24	$357.65	$565.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $303.12 / $341.39 / $479.72	Professional		$303.12	$341.39	$479.72