Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $382.00 / $1,992.00 / $6,762.00	Facility		$382.00	$1,992.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $185.87 / $220.89 / $348.00	Facility	54	$185.87	$220.89	$348.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.72 / $302.29 / $525.86	Professional		$259.72	$302.29	$525.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $276.08 / $352.92 / $398.95	Professional		$276.08	$352.92	$398.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.08 / $347.18 / $790.83	Facility		$194.08	$347.18	$790.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.06 / $319.24 / $479.29	Professional		$258.06	$319.24	$479.29
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $165.79 / $282.79 / $895.50	Facility		$165.79	$282.79	$895.50
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $319.66 / $429.63 / $552.38	Professional		$319.66	$429.63	$552.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $196.95 / $196.95 / $284.20	Facility		$196.95	$196.95	$284.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $494.57 / $494.57 / $494.57	Facility		$494.57	$494.57	$494.57
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $346.20 / $346.20 / $346.20	Facility	54	$346.20	$346.20	$346.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.36 / $390.92 / $601.03	Professional		$296.36	$390.92	$601.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,399.20 / $11,500.00 / $12,000.00	Facility		$1,399.20	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $956.89 / $1,081.52 / $1,081.52	Facility	54	$956.89	$1,081.52	$1,081.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,155.44 / $2,406.08 / $2,780.93	Professional		$2,155.44	$2,406.08	$2,780.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $273.99 / $356.79 / $566.04	Facility		$273.99	$356.79	$566.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $367.15 / $446.90 / $569.88	Professional		$367.15	$446.90	$569.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $348.85 / $549.67 / $1,143.33	Professional		$348.85	$549.67	$1,143.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $275.62 / $361.08 / $586.95	Facility		$275.62	$361.08	$586.95
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $346.20 / $346.20 / $607.71	Facility	54	$346.20	$346.20	$607.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $301.00 / $416.22 / $637.84	Professional		$301.00	$416.22	$637.84
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 $244.08 / $337.40 / $531.69	Professional		$244.08	$337.40	$531.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $272.48 / $306.88 / $431.54	Professional		$272.48	$306.88	$431.54