Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $2,754.23 / $6,918.31	Facility		$446.68	$2,754.23	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,698.24 / $3,467.37 / $19,952.62	Facility	50	$1,698.24	$3,467.37	$19,952.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $275.42 / $602.56	Professional		$158.49	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $549.54 / $1,659.59	Professional	50	$354.81	$549.54	$1,659.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $263.03 / $371.54	Professional		$158.49	$263.03	$371.54
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $371.54 / $426.58 / $602.56	Professional	50	$371.54	$426.58	$602.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,344.23 / $4,786.30	Facility		$1,318.26	$2,344.23	$4,786.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $213.80 / $331.13	Professional		$131.83	$213.80	$331.13
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,778.28 / $3,981.07	Facility		$707.95	$1,778.28	$3,981.07
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $363.08	Professional		$147.91	$177.83	$363.08
Christus Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $1,412.54 / $1,412.54	Facility		$134.90	$1,412.54	$1,412.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,148.15	Facility		$1,148.15	$1,148.15	$1,148.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $524.81	Professional		$173.78	$295.12	$524.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $28,840.32 / $28,840.32	Facility		$5,248.07	$28,840.32	$28,840.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $389.05 / $3,715.35	Facility		$181.97	$389.05	$3,715.35
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $954.99 / $3,467.37 / $19,952.62	Facility	50	$954.99	$3,467.37	$19,952.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $275.42 / $537.03	Professional		$158.49	$275.42	$537.03
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $346.74 / $575.44 / $1,659.59	Professional	50	$346.74	$575.44	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $676.08 / $812.83	Professional		$5.01	$676.08	$812.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $302.00 / $588.84	Facility		$169.82	$302.00	$588.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $524.81	Professional		$173.78	$295.12	$524.81
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,511.89 / $4,786.30	Facility		$724.44	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $245.47 / $426.58	Professional		$147.91	$245.47	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $269.15 / $269.15	Professional		$257.04	$269.15	$269.15