Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,198.00 / $4,028.00 / $11,348.00	Facility		$1,198.00	$4,028.00	$11,348.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,868.26 / $3,868.26 / $3,868.26	Facility	22	$3,868.26	$3,868.26	$3,868.26
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $315.00 / $315.00 / $315.00	Facility	AS	$315.00	$315.00	$315.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $890.96 / $1,084.61 / $1,876.39	Professional		$890.96	$1,084.61	$1,876.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,019.18 / $1,121.09 / $1,381.93	Professional		$1,019.18	$1,121.09	$1,381.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,157.91 / $9,212.20 / $17,945.84	Facility		$5,157.91	$9,212.20	$17,945.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $857.98 / $1,065.45 / $1,661.47	Professional		$857.98	$1,065.45	$1,661.47
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,036.91 / $6,495.05 / $13,783.75	Facility		$1,036.91	$6,495.05	$13,783.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $610.91 / $1,273.98 / $1,783.57	Professional		$610.91	$1,273.98	$1,783.57
Christus Facility/Professional Facility Modifier Low / Median / High Price $952.45 / $5,680.37 / $5,680.37	Facility		$952.45	$5,680.37	$5,680.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,211.14 / $1,211.14 / $1,211.14	Facility		$1,211.14	$1,211.14	$1,211.14
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $120.27 / $120.27 / $120.27	Facility	AS	$120.27	$120.27	$120.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,055.58 / $1,426.98 / $2,212.28	Professional		$1,055.58	$1,426.98	$2,212.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,986.80 / $19,913.50 / $26,542.00	Facility		$5,986.80	$19,913.50	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $242.33 / $1,887.52 / $1,887.52	Facility	AS	$242.33	$1,887.52	$1,887.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,718.96 / $7,887.28 / $9,162.98	Professional		$7,718.96	$7,887.28	$9,162.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,039.95 / $1,365.60 / $2,230.17	Facility		$1,039.95	$1,365.60	$2,230.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,180.80 / $1,605.13 / $2,021.63	Professional		$1,180.80	$1,605.13	$2,021.63
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,334.31 / $3,419.00 / $12,361.00	Facility		$2,334.31	$3,419.00	$12,361.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,019.18 / $1,415.66 / $2,390.56	Professional		$1,019.18	$1,415.66	$2,390.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,039.95 / $1,362.31 / $2,175.44	Facility		$1,039.95	$1,362.31	$2,175.44
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $407.41 / $407.41 / $407.41	Facility	80	$407.41	$407.41	$407.41
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $120.27 / $120.27 / $346.30	Facility	AS	$120.27	$120.27	$346.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,086.56 / $1,476.41 / $2,244.65	Professional		$1,086.56	$1,476.41	$2,244.65
United Facility/Professional Facility Modifier Low / Median / High Price $2,605.00 / $7,350.00 / $16,000.00	Facility		$2,605.00	$7,350.00	$16,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $864.01 / $1,148.85 / $1,836.02	Professional		$864.01	$1,148.85	$1,836.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $896.39 / $1,019.18 / $1,413.34	Professional		$896.39	$1,019.18	$1,413.34