Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $287.58 / $2,514.00 / $7,495.00	Facility		$287.58	$2,514.00	$7,495.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,353.75 / $3,203.20 / $10,604.93	Facility	50	$1,353.75	$3,203.20	$10,604.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.53 / $255.18 / $373.58	Professional		$165.53	$255.18	$373.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $125.28 / $384.23 / $484.17	Professional	50	$125.28	$384.23	$484.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.25 / $79.25 / $79.25	Professional		$79.25	$79.25	$79.25
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $118.87 / $118.87 / $118.87	Professional	50	$118.87	$118.87	$118.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,273.24 / $2,274.67 / $4,835.46	Facility		$1,273.24	$2,274.67	$4,835.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.05 / $201.58 / $329.52	Professional		$133.05	$201.58	$329.52
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $532.79 / $2,628.43 / $8,727.29	Facility		$532.79	$2,628.43	$8,727.29
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $114.91 / $229.81 / $349.48	Professional		$114.91	$229.81	$349.48
Christus Facility/Professional Facility Modifier Low / Median / High Price $141.58 / $1,168.40 / $1,168.40	Facility		$141.58	$1,168.40	$1,168.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,137.07 / $1,137.07 / $1,137.07	Facility		$1,137.07	$1,137.07	$1,137.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.21 / $292.89 / $550.39	Professional		$181.21	$292.89	$550.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,143.42 / $12,000.00 / $12,000.00	Facility		$1,143.42	$12,000.00	$12,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,164.00 / $2,210.82 / $2,210.82	Professional		$2,164.00	$2,210.82	$2,210.82
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $177.75 / $313.33 / $605.21	Facility		$177.75	$313.33	$605.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $211.51 / $302.62 / $450.07	Professional		$211.51	$302.62	$450.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $383.40 / $383.40 / $383.40	Professional		$383.40	$383.40	$383.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $177.90 / $320.38 / $621.54	Facility		$177.90	$320.38	$621.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $185.91 / $306.05 / $560.89	Professional		$185.91	$306.05	$560.89
United Facility/Professional Facility Modifier Low / Median / High Price $564.00 / $2,064.00 / $4,509.00	Facility		$564.00	$2,064.00	$4,509.00
United Facility/Professional Professional Modifier Low / Median / High Price $218.07 / $304.69 / $490.19	Professional		$218.07	$304.69	$490.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.40 / $241.02 / $338.18	Professional		$213.40	$241.02	$338.18