Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.63 / $2,090.00 / $7,316.00	Facility		$154.63	$2,090.00	$7,316.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $76.48 / $83.39 / $141.82	Facility	54	$76.48	$83.39	$141.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.23 / $121.04 / $207.84	Professional		$102.23	$121.04	$207.84
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $78.47 / $91.83 / $145.22	Professional	54	$78.47	$91.83	$145.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.43 / $95.43 / $95.43	Professional		$95.43	$95.43	$95.43
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $136.50 / $136.50 / $136.50	Professional	54	$136.50	$136.50	$136.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.48 / $113.55 / $436.19	Facility		$70.48	$113.55	$436.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.19 / $136.07 / $193.78	Professional		$112.19	$136.07	$193.78
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $124.09 / $171.36 / $212.72	Professional		$124.09	$171.36	$212.72
Christus Facility/Professional Facility Modifier Low / Median / High Price $120.86 / $145.76 / $145.76	Facility		$120.86	$145.76	$145.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.36 / $141.36 / $141.36	Facility		$141.36	$141.36	$141.36
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $94.65 / $94.65 / $94.65	Facility	54	$94.65	$94.65	$94.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.77 / $158.72 / $249.14	Professional		$123.77	$158.72	$249.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $2,165.76	Facility		$55.00	$55.00	$2,165.76
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $204.20 / $301.91 / $402.69	Facility	54	$204.20	$301.91	$402.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $913.28 / $931.20 / $1,064.09	Professional		$913.28	$931.20	$1,064.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $110.02 / $144.25 / $239.84	Facility		$110.02	$144.25	$239.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.19 / $175.53 / $228.63	Professional		$144.19	$175.53	$228.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.57 / $224.57 / $470.09	Professional		$138.57	$224.57	$470.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $110.50 / $145.83 / $253.20	Facility		$110.50	$145.83	$253.20
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $94.65 / $94.65 / $228.70	Facility	54	$94.65	$94.65	$228.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.67 / $165.78 / $253.91	Professional		$125.67	$165.78	$253.91
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $179.42 / $190.85 / $222.14	Professional	54	$179.42	$190.85	$222.14
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 $96.37 / $129.66 / $200.83	Professional		$96.37	$129.66	$200.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.91 / $118.18 / $166.46	Professional		$104.91	$118.18	$166.46