Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $370.21 / $2,131.00 / $7,513.00	Facility		$370.21	$2,131.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $147.43 / $172.76 / $277.66	Facility	54	$147.43	$172.76	$277.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.51 / $243.08 / $423.46	Professional		$209.51	$243.08	$423.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $229.13 / $259.14	Professional		$137.69	$229.13	$259.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $187.11 / $342.87 / $773.64	Facility		$187.11	$342.87	$773.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.77 / $270.83 / $380.50	Professional		$215.77	$270.83	$380.50
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $224.37 / $334.11 / $482.36	Professional		$224.37	$334.11	$482.36
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $226.59 / $226.59	Facility		$80.00	$226.59	$226.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $394.02 / $394.02 / $394.02	Facility		$394.02	$394.02	$394.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $275.81 / $275.81 / $275.81	Facility	54	$275.81	$275.81	$275.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.21 / $311.83 / $482.37	Professional		$237.21	$311.83	$482.37
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,117.64 / $11,500.00 / $12,000.00	Facility		$1,117.64	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $764.03 / $868.62 / $868.62	Facility	54	$764.03	$868.62	$868.62
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,726.16 / $1,896.64 / $2,181.30	Professional		$1,726.16	$1,896.64	$2,181.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $224.34 / $288.00 / $453.30	Facility		$224.34	$288.00	$453.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $294.43 / $356.83 / $448.05	Professional		$294.43	$356.83	$448.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $265.52 / $438.65 / $915.26	Professional		$265.52	$438.65	$915.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $224.37 / $290.62 / $470.25	Facility		$224.37	$290.62	$470.25
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $275.81 / $275.81 / $474.74	Facility	54	$275.81	$275.81	$474.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $241.18 / $329.82 / $504.53	Professional		$241.18	$329.82	$504.53
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $864.00 / $2,376.00	Facility		$161.00	$864.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $193.32 / $266.68 / $417.59	Professional		$193.32	$266.68	$417.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $214.23 / $241.18 / $339.59	Professional		$214.23	$241.18	$339.59