Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $828.00 / $3,431.00 / $8,041.00	Facility		$828.00	$3,431.00	$8,041.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,894.50 / $4,665.00 / $10,132.64	Facility	50	$1,894.50	$4,665.00	$10,132.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $430.85 / $521.73 / $861.20	Professional		$430.85	$521.73	$861.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $272.49 / $505.77 / $653.97	Professional		$272.49	$505.77	$653.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,336.44 / $2,222.84 / $4,838.74	Facility		$1,336.44	$2,222.84	$4,838.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $414.40 / $515.79 / $802.48	Professional		$414.40	$515.79	$802.48
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,341.26 / $2,142.40 / $7,500.00	Facility		$1,341.26	$2,142.40	$7,500.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $544.97 / $678.08 / $946.43	Professional		$544.97	$678.08	$946.43
Christus Facility/Professional Facility Modifier Low / Median / High Price $471.98 / $1,649.18 / $1,649.18	Facility		$471.98	$1,649.18	$1,649.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $589.59 / $589.59 / $589.59	Facility		$589.59	$589.59	$589.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $500.28 / $672.34 / $1,042.38	Professional		$500.28	$672.34	$1,042.38
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,943.56 / $13,152.00 / $26,542.00	Facility		$1,943.56	$13,152.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,773.76 / $3,839.44 / $4,470.75	Professional		$3,773.76	$3,839.44	$4,470.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $484.73 / $602.84 / $968.85	Facility		$484.73	$602.84	$968.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $589.59 / $769.04 / $953.60	Professional		$589.59	$769.04	$953.60
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $383.50 / $2,499.00 / $5,733.00	Facility		$383.50	$2,499.00	$5,733.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $495.43 / $665.49 / $1,064.78	Professional		$495.43	$665.49	$1,064.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $486.95 / $604.64 / $1,006.46	Facility		$486.95	$604.64	$1,006.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $524.45 / $694.86 / $1,070.10	Professional		$524.45	$694.86	$1,070.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,345.00 / $10,600.00	Facility		$1,634.00	$4,345.00	$10,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $397.97 / $545.40 / $848.89	Professional		$397.97	$545.40	$848.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $437.57 / $495.43 / $691.23	Professional		$437.57	$495.43	$691.23