Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.53 / $1,841.00 / $6,000.00	Facility		$217.53	$1,841.00	$6,000.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $31.66 / $97.23 / $140.66	Facility	52	$31.66	$97.23	$140.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.32 / $185.02 / $325.29	Professional		$63.32	$185.02	$325.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.66 / $83.21 / $118.93	Professional	52	$31.66	$83.21	$118.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.28 / $59.28 / $60.90	Professional		$59.28	$59.28	$60.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.56 / $120.23 / $459.57	Facility		$73.56	$120.23	$459.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.98 / $144.96 / $268.30	Professional		$57.98	$144.96	$268.30
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $167.10 / $244.04 / $1,385.45	Facility		$167.10	$244.04	$1,385.45
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $60.87 / $240.25 / $313.83	Professional		$60.87	$240.25	$313.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $53.83 / $185.10 / $185.10	Facility		$53.83	$185.10	$185.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.91 / $149.91 / $149.91	Facility		$149.91	$149.91	$149.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.62 / $187.10 / $349.18	Professional		$69.62	$187.10	$349.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $451.14	Facility		$55.00	$55.00	$451.14
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $233.74 / $252.78 / $252.78	Facility	52	$233.74	$252.78	$252.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $927.00 / $1,361.68 / $1,601.63	Professional		$927.00	$1,361.68	$1,601.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.14 / $185.87 / $360.16	Facility		$68.14	$185.87	$360.16
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.16 / $239.27 / $322.08	Professional		$81.16	$239.27	$322.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $161.69 / $229.36	Professional		$56.98	$161.69	$229.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.37 / $186.07 / $413.66	Facility		$68.37	$186.07	$413.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $71.73 / $196.45 / $354.61	Professional		$71.73	$196.45	$354.61
United Facility/Professional Facility Modifier Low / Median / High Price $146.00 / $931.00 / $2,290.00	Facility		$146.00	$931.00	$2,290.00
United Facility/Professional Professional Modifier Low / Median / High Price $159.25 / $217.55 / $336.21	Professional		$159.25	$217.55	$336.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $157.08 / $175.83 / $249.49	Professional		$157.08	$175.83	$249.49