Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $273.30 / $2,068.00 / $7,316.00	Facility		$273.30	$2,068.00	$7,316.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $135.47 / $168.11 / $255.15	Facility	54	$135.47	$168.11	$255.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.25 / $229.49 / $416.05	Professional		$196.25	$229.49	$416.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $167.03 / $666.84	Facility		$94.80	$167.03	$666.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.92 / $250.51 / $357.70	Professional		$197.92	$250.51	$357.70
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $206.18 / $329.89 / $467.38	Professional		$206.18	$329.89	$467.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $210.19 / $210.19	Facility		$80.00	$210.19	$210.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $362.57 / $362.57 / $362.57	Facility		$362.57	$362.57	$362.57
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $253.80	Facility	54	$253.80	$253.80	$253.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.65 / $296.89 / $449.09	Professional		$222.65	$296.89	$449.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,134.73	Facility		$55.00	$55.00	$1,134.73
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $701.49 / $794.31 / $794.31	Facility	54	$701.49	$794.31	$794.31
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,583.52 / $1,835.84 / $2,115.60	Professional		$1,583.52	$1,835.84	$2,115.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $210.94 / $269.77 / $429.57	Facility		$210.94	$269.77	$429.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $278.37 / $340.55 / $434.20	Professional		$278.37	$340.55	$434.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.05 / $424.48 / $843.71	Professional		$251.05	$424.48	$843.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $210.94 / $271.70 / $436.78	Facility		$210.94	$271.70	$436.78
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $461.89	Facility	54	$253.80	$253.80	$461.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $223.12 / $311.83 / $472.79	Professional		$223.12	$311.83	$472.79
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $2,405.00	Facility		$161.00	$950.00	$2,405.00
United Facility/Professional Professional Modifier Low / Median / High Price $185.41 / $248.32 / $388.98	Professional		$185.41	$248.32	$388.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $207.61 / $233.69 / $329.02	Professional		$207.61	$233.69	$329.02