Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $748.00 / $3,000.00 / $10,893.00	Facility		$748.00	$3,000.00	$10,893.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $547.59 / $824.75 / $1,419.41	Professional		$547.59	$824.75	$1,419.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $321.10 / $573.39 / $1,103.99	Professional		$321.10	$573.39	$1,103.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,606.10 / $8,972.92 / $18,364.59	Facility		$4,606.10	$8,972.92	$18,364.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.65 / $862.14 / $1,306.97	Professional		$549.65	$862.14	$1,306.97
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $673.20 / $12,081.69 / $18,166.82	Facility		$673.20	$12,081.69	$18,166.82
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $630.73 / $738.08 / $987.31	Professional		$630.73	$738.08	$987.31
Christus Facility/Professional Facility Modifier Low / Median / High Price $549.59 / $5,924.93 / $5,924.93	Facility		$549.59	$5,924.93	$5,924.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,021.88 / $1,021.88 / $1,021.88	Facility		$1,021.88	$1,021.88	$1,021.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $102.19 / $102.19 / $102.19	Facility	AS	$102.19	$102.19	$102.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $647.92 / $1,027.82 / $1,708.58	Professional		$647.92	$1,027.82	$1,708.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,845.24 / $11,500.00 / $26,542.00	Facility		$2,845.24	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $275.97 / $304.38 / $304.38	Facility	AS	$275.97	$304.38	$304.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,414.80 / $7,266.00 / $8,437.79	Professional		$4,414.80	$7,266.00	$8,437.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $618.50 / $938.13 / $1,501.87	Facility		$618.50	$938.13	$1,501.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $737.10 / $1,096.80 / $1,742.55	Professional		$737.10	$1,096.80	$1,742.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $584.42 / $1,021.90 / $2,129.67	Professional		$584.42	$1,021.90	$2,129.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $618.50 / $945.43 / $1,515.14	Facility		$618.50	$945.43	$1,515.14
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $395.98 / $395.98 / $395.98	Facility	80	$395.98	$395.98	$395.98
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $102.19 / $102.19 / $336.58	Facility	AS	$102.19	$102.19	$336.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $661.49 / $1,093.71 / $1,877.34	Professional		$661.49	$1,093.71	$1,877.34
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,345.00 / $10,600.00	Facility		$1,634.00	$4,345.00	$10,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $714.65 / $1,004.18 / $1,632.41	Professional		$714.65	$1,004.18	$1,632.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $833.17 / $938.67 / $1,322.61	Professional		$833.17	$938.67	$1,322.61