Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $945.00 / $3,682.00 / $12,480.00	Facility		$945.00	$3,682.00	$12,480.00
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $81.48 / $81.48 / $81.48	Facility	AS	$81.48	$81.48	$81.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,629.20 / $17,851.06 / $34,924.07	Facility		$7,629.20	$17,851.06	$34,924.07
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $756.28 / $8,100.00 / $13,920.18	Facility		$756.28	$8,100.00	$13,920.18
Christus Facility/Professional Facility Modifier Low / Median / High Price $711.60 / $7,229.48 / $7,229.48	Facility		$711.60	$7,229.48	$7,229.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $883.12 / $883.12 / $883.12	Facility		$883.12	$883.12	$883.12
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $87.84 / $87.84 / $87.84	Facility	AS	$87.84	$87.84	$87.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,910.40 / $26,542.00 / $53,585.20	Facility		$2,910.40	$26,542.00	$53,585.20
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $179.10 / $5,079.12 / $5,079.12	Facility	AS	$179.10	$5,079.12	$5,079.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $762.74 / $1,012.31 / $1,580.45	Facility		$762.74	$1,012.31	$1,580.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $762.74 / $1,019.95 / $1,610.91	Facility		$762.74	$1,019.95	$1,610.91
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $295.63 / $295.63 / $295.63	Facility	80	$295.63	$295.63	$295.63
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $87.84 / $87.84 / $251.29	Facility	AS	$87.84	$87.84	$251.29
United Facility/Professional Facility Modifier Low / Median / High Price $2,605.00 / $7,184.00 / $16,000.00	Facility		$2,605.00	$7,184.00	$16,000.00