Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $329.39 / $2,128.00 / $7,513.00	Facility		$329.39	$2,128.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $122.96 / $147.62 / $231.31	Facility	54	$122.96	$147.62	$231.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.38 / $205.10 / $342.40	Professional		$176.38	$205.10	$342.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $215.89 / $215.89 / $215.89	Professional		$215.89	$215.89	$215.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $164.53 / $666.84	Facility		$94.80	$164.53	$666.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.52 / $225.97 / $321.72	Professional		$178.52	$225.97	$321.72
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $208.73 / $271.02 / $336.46	Professional		$208.73	$271.02	$336.46
Christus Facility/Professional Facility Modifier Low / Median / High Price $176.89 / $176.89 / $188.68	Facility		$176.89	$176.89	$188.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $328.64 / $328.64 / $328.64	Facility		$328.64	$328.64	$328.64
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $230.05	Facility	54	$230.05	$230.05	$230.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.57 / $264.30 / $409.73	Professional		$200.57	$264.30	$409.73
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,031.60	Facility		$55.00	$55.00	$1,031.60
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $635.79 / $722.13 / $722.13	Facility	54	$635.79	$722.13	$722.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,440.80 / $1,669.19 / $1,856.18	Professional		$1,440.80	$1,669.19	$1,856.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $190.79 / $248.44 / $388.17	Facility		$190.79	$248.44	$388.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $247.45 / $299.77 / $382.22	Professional		$247.45	$299.77	$382.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $227.53 / $257.33 / $357.85	Professional		$227.53	$257.33	$357.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $190.79 / $249.11 / $399.31	Facility		$190.79	$249.11	$399.31
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $405.35	Facility	54	$230.05	$230.05	$405.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $202.18 / $280.80 / $427.38	Professional		$202.18	$280.80	$427.38
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 $166.86 / $230.01 / $354.61	Professional		$166.86	$230.01	$354.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $182.75 / $205.87 / $289.87	Professional		$182.75	$205.87	$289.87