Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $2,128.00 / $7,513.00	Facility		$425.00	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $198.13 / $233.57 / $375.25	Facility	54	$198.13	$233.57	$375.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.68 / $321.33 / $567.42	Professional		$276.68	$321.33	$567.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $328.30 / $328.30 / $350.23	Professional		$328.30	$328.30	$350.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $191.92 / $347.18 / $769.83	Facility		$191.92	$347.18	$769.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.64 / $365.48 / $511.94	Professional		$289.64	$365.48	$511.94
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $165.79 / $238.52 / $925.31	Facility		$165.79	$238.52	$925.31
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $333.55 / $424.52 / $531.78	Professional		$333.55	$424.52	$531.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $309.31 / $309.31	Facility		$80.00	$309.31	$309.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $533.14 / $533.14 / $533.14	Facility		$533.14	$533.14	$533.14
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $373.20 / $373.20 / $373.20	Facility	54	$373.20	$373.20	$373.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.99 / $416.82 / $636.51	Professional		$314.99	$416.82	$636.51
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,500.88 / $11,500.00 / $12,000.00	Facility		$1,500.88	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,032.09 / $1,166.88 / $1,166.88	Facility	54	$1,032.09	$1,166.88	$1,166.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,323.04 / $2,561.19 / $2,977.43	Professional		$2,323.04	$2,561.19	$2,977.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $292.13 / $377.85 / $603.40	Facility		$292.13	$377.85	$603.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $400.67 / $482.03 / $614.84	Professional		$400.67	$482.03	$614.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $376.14 / $594.27 / $1,223.07	Professional		$376.14	$594.27	$1,223.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $293.01 / $381.84 / $621.09	Facility		$293.01	$381.84	$621.09
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $373.20 / $373.20 / $642.40	Facility	54	$373.20	$373.20	$642.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $324.26 / $441.69 / $676.46	Professional		$324.26	$441.69	$676.46
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 $258.77 / $356.20 / $551.29	Professional		$258.77	$356.20	$551.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $291.52 / $328.30 / $461.63	Professional		$291.52	$328.30	$461.63