Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $465.25 / $1,938.00 / $6,762.00	Facility		$465.25	$1,938.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $277.82 / $342.11 / $531.77	Facility	54	$277.82	$342.11	$531.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $406.94 / $474.81 / $814.45	Professional		$406.94	$474.81	$814.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $300.80 / $749.12 / $977.59	Professional		$300.80	$749.12	$977.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,100.00 / $2,141.52 / $4,277.00	Facility		$1,100.00	$2,141.52	$4,277.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $394.28 / $489.93 / $728.98	Professional		$394.28	$489.93	$728.98
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $165.79 / $425.89 / $4,100.00	Facility		$165.79	$425.89	$4,100.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $408.53 / $408.53 / $461.83	Facility		$408.53	$408.53	$461.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $761.30 / $761.30 / $761.30	Facility		$761.30	$761.30	$761.30
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $532.91 / $532.91 / $532.91	Facility	54	$532.91	$532.91	$532.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $456.36 / $604.60 / $919.49	Professional		$456.36	$604.60	$919.49
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,116.52 / $11,500.00 / $12,000.00	Facility		$2,116.52	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,455.99 / $1,609.10 / $1,609.10	Facility	54	$1,455.99	$1,609.10	$1,609.10
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,262.96 / $3,741.04 / $4,364.78	Professional		$3,262.96	$3,741.04	$4,364.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $442.37 / $575.79 / $902.93	Facility		$442.37	$575.79	$902.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $566.66 / $699.20 / $898.97	Professional		$566.66	$699.20	$898.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $545.65 / $862.37 / $1,729.28	Professional		$545.65	$862.37	$1,729.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $442.37 / $578.00 / $924.65	Facility		$442.37	$578.00	$924.65
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $532.91 / $532.91 / $943.04	Facility	54	$532.91	$532.91	$943.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $461.63 / $645.39 / $972.02	Professional		$461.63	$645.39	$972.02
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 $386.94 / $519.17 / $814.39	Professional		$386.94	$519.17	$814.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $426.25 / $481.67 / $673.42	Professional		$426.25	$481.67	$673.42