Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $3,682.00 / $12,826.00	Facility		$921.00	$3,682.00	$12,826.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $555.91 / $865.70 / $1,405.27	Professional		$555.91	$865.70	$1,405.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $518.80 / $571.55 / $1,074.27	Professional		$518.80	$571.55	$1,074.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,147.82 / $8,614.01 / $15,618.87	Facility		$3,147.82	$8,614.01	$15,618.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $538.95 / $854.35 / $1,280.13	Professional		$538.95	$854.35	$1,280.13
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $685.00 / $4,050.00 / $12,311.28	Facility		$685.00	$4,050.00	$12,311.28
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $600.14 / $820.75 / $1,057.39	Professional		$600.14	$820.75	$1,057.39
Christus Facility/Professional Facility Modifier Low / Median / High Price $551.16 / $5,720.85 / $5,720.85	Facility		$551.16	$5,720.85	$5,720.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,018.68 / $1,018.68 / $1,018.68	Facility		$1,018.68	$1,018.68	$1,018.68
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $101.87 / $101.87 / $101.87	Facility	AS	$101.87	$101.87	$101.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.18 / $1,078.69 / $1,703.18	Professional		$660.18	$1,078.69	$1,703.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,818.80 / $11,500.00 / $26,542.00	Facility		$2,818.80	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $275.06 / $303.51 / $303.51	Facility	AS	$275.06	$303.51	$303.51
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,137.00 / $7,255.04 / $8,417.25	Professional		$5,137.00	$7,255.04	$8,417.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $616.57 / $987.76 / $1,505.12	Facility		$616.57	$987.76	$1,505.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $734.68 / $1,093.20 / $1,739.09	Professional		$734.68	$1,093.20	$1,739.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $586.11 / $1,024.54 / $2,141.29	Professional		$586.11	$1,024.54	$2,141.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $617.13 / $990.76 / $1,509.84	Facility		$617.13	$990.76	$1,509.84
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $383.90 / $383.90 / $383.90	Facility	80	$383.90	$383.90	$383.90
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $101.87 / $101.87 / $326.31	Facility	AS	$101.87	$101.87	$326.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $670.41 / $1,125.74 / $1,882.44	Professional		$670.41	$1,125.74	$1,882.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,405.00 / $10,600.00	Facility		$1,634.00	$4,405.00	$10,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $779.22 / $1,050.21 / $1,624.67	Professional		$779.22	$1,050.21	$1,624.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.52 / $936.85 / $1,320.14	Professional		$831.52	$936.85	$1,320.14