Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $458.04 / $1,860.00 / $6,021.00	Facility		$458.04	$1,860.00	$6,021.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $270.95 / $330.27 / $516.61	Facility	54	$270.95	$330.27	$516.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $394.14 / $462.55 / $813.35	Professional		$394.14	$462.55	$813.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $949.73 / $949.73 / $949.73	Professional		$949.73	$949.73	$949.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,093.45 / $2,141.52 / $4,277.00	Facility		$1,093.45	$2,141.52	$4,277.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.29 / $509.21 / $729.26	Professional		$402.29	$509.21	$729.26
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $414.89 / $1,539.15 / $2,011.81	Facility		$414.89	$1,539.15	$2,011.81
Christus Facility/Professional Facility Modifier Low / Median / High Price $449.87 / $563.73 / $563.73	Facility		$449.87	$563.73	$563.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $738.59 / $738.59 / $738.59	Facility		$738.59	$738.59	$738.59
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $517.01 / $517.01 / $517.01	Facility	54	$517.01	$517.01	$517.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $444.22 / $588.32 / $896.50	Professional		$444.22	$588.32	$896.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,061.40 / $11,500.00 / $12,000.00	Facility		$2,061.40	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,415.72 / $1,570.70 / $1,570.70	Facility	54	$1,415.72	$1,570.70	$1,570.70
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,173.92 / $3,606.48 / $4,200.30	Professional		$3,173.92	$3,606.48	$4,200.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $430.20 / $562.90 / $869.65	Facility		$430.20	$562.90	$869.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $552.77 / $672.94 / $865.21	Professional		$552.77	$672.94	$865.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $526.60 / $835.85 / $1,683.44	Professional		$526.60	$835.85	$1,683.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $431.36 / $565.84 / $888.92	Facility		$431.36	$565.84	$888.92
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $517.01 / $517.01 / $910.28	Facility	54	$517.01	$517.01	$910.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $449.58 / $622.67 / $937.19	Professional		$449.58	$622.67	$937.19
United Facility/Professional Facility Modifier Low / Median / High Price $374.00 / $1,529.00 / $3,400.00	Facility		$374.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $367.54 / $500.64 / $784.71	Professional		$367.54	$500.64	$784.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $410.24 / $463.32 / $648.29	Professional		$410.24	$463.32	$648.29