Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $644.25 / $2,742.00 / $7,975.00	Facility		$644.25	$2,742.00	$7,975.00
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $85.00 / $85.00 / $85.00	Facility	AS	$85.00	$85.00	$85.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.41 / $219.48 / $729.36	Professional		$154.41	$219.48	$729.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.55 / $188.56 / $232.19	Professional		$162.55	$188.56	$232.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,711.00 / $4,637.80 / $14,543.00	Facility		$1,711.00	$4,637.80	$14,543.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.79 / $170.27 / $264.89	Professional		$136.79	$170.27	$264.89
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $155.75 / $1,050.00 / $4,050.00	Facility		$155.75	$1,050.00	$4,050.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $89.41 / $121.92 / $499.00	Professional		$89.41	$121.92	$499.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $144.91 / $165.52 / $165.52	Facility		$144.91	$165.52	$165.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.23 / $194.23 / $194.23	Facility		$194.23	$194.23	$194.23
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $19.01 / $19.01 / $19.01	Facility	AS	$19.01	$19.01	$19.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.90 / $253.51 / $1,090.46	Professional		$175.90	$253.51	$1,090.46
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,010.99 / $11,500.00 / $26,542.00	Facility		$2,010.99	$11,500.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $85.28 / $236.38 / $236.38	Facility	AS	$85.28	$236.38	$236.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,110.16 / $5,110.16 / $5,110.16	Professional		$5,110.16	$5,110.16	$5,110.16
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $165.68 / $387.37 / $1,192.30	Facility		$165.68	$387.37	$1,192.30
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $188.69 / $254.87 / $840.25	Professional		$188.69	$254.87	$840.25
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,186.85 / $4,387.64 / $10,626.81	Facility		$3,186.85	$4,387.64	$10,626.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $160.19 / $226.72 / $573.10	Professional		$160.19	$226.72	$573.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $165.68 / $396.50 / $1,171.68	Facility		$165.68	$396.50	$1,171.68
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $65.52 / $65.52 / $65.52	Facility	80	$65.52	$65.52	$65.52
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $19.01 / $19.01 / $55.70	Facility	AS	$19.01	$19.01	$55.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $178.21 / $262.18 / $1,080.66	Professional		$178.21	$262.18	$1,080.66
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $2,290.00	Facility		$161.00	$950.00	$2,290.00
United Facility/Professional Professional Modifier Low / Median / High Price $145.79 / $200.48 / $819.01	Professional		$145.79	$200.48	$819.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $142.16 / $162.55 / $223.64	Professional		$142.16	$162.55	$223.64