Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $276.39 / $1,937.00 / $6,386.00	Facility		$276.39	$1,937.00	$6,386.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $844.03 / $844.03 / $3,458.98	Facility	50	$844.03	$844.03	$3,458.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $187.41 / $309.89	Professional		$75.06	$187.41	$309.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.99 / $403.72 / $473.83	Professional	50	$55.99	$403.72	$473.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.34 / $239.07 / $239.07	Professional		$223.34	$239.07	$239.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.08 / $173.36 / $405.45	Facility		$99.08	$173.36	$405.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.47 / $200.73 / $360.54	Professional		$71.47	$200.73	$360.54
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $37.35 / $231.52 / $3,138.20	Facility		$37.35	$231.52	$3,138.20
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $53.33 / $104.15 / $446.68	Professional		$53.33	$104.15	$446.68
Christus Facility/Professional Facility Modifier Low / Median / High Price $68.70 / $99.88 / $99.88	Facility		$68.70	$99.88	$99.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.15 / $100.15 / $100.15	Facility		$100.15	$100.15	$100.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $221.28 / $365.47	Professional		$84.56	$221.28	$365.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $523.74 / $12,000.00 / $12,000.00	Facility		$523.74	$12,000.00	$12,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $915.62 / $1,723.12 / $2,036.70	Professional		$915.62	$1,723.12	$2,036.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.06 / $203.89 / $350.92	Facility		$80.06	$203.89	$350.92
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.55 / $256.89 / $408.70	Professional		$97.55	$256.89	$408.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $201.60 / $201.60 / $201.60	Professional		$201.60	$201.60	$201.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $79.36 / $204.55 / $371.75	Facility		$79.36	$204.55	$371.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $233.36 / $405.90	Professional		$87.28	$233.36	$405.90
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $1,058.00 / $2,667.00	Facility		$161.00	$1,058.00	$2,667.00
United Facility/Professional Professional Modifier Low / Median / High Price $170.62 / $235.92 / $388.36	Professional		$170.62	$235.92	$388.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $199.32 / $223.34 / $316.22	Professional		$199.32	$223.34	$316.22