Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $2,187.76 / $6,165.95	Facility		$537.03	$2,187.76	$6,165.95
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $660.69 / $1,318.26 / $3,467.37	Facility	50	$660.69	$1,318.26	$3,467.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $173.78 / $295.12	Professional		$102.33	$173.78	$295.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $114.82 / $363.08	Professional	50	$38.90	$114.82	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $123.03 / $263.03	Professional	50	$123.03	$123.03	$263.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,290.87 / $4,677.35	Facility		$1,318.26	$2,290.87	$4,677.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $177.83 / $245.47	Professional		$144.54	$177.83	$245.47
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $1,778.28 / $4,466.84	Facility		$426.58	$1,778.28	$4,466.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Christus Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
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 $162.18 / $213.80 / $354.81	Professional		$162.18	$213.80	$354.81
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 $2,511.89 / $2,511.89 / $2,511.89	Professional		$2,511.89	$2,511.89	$2,511.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $398.11 / $4,265.80	Facility		$154.88	$398.11	$4,265.80
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $467.74 / $1,445.44 / $5,888.44	Facility	50	$467.74	$1,445.44	$5,888.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $190.55 / $354.81	Professional		$144.54	$190.55	$354.81
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $57.54 / $114.82 / $933.25	Professional	50	$57.54	$114.82	$933.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $323.59 / $398.11	Professional		$5.01	$323.59	$398.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $218.78 / $398.11	Facility		$144.54	$218.78	$398.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $213.80 / $354.81	Professional		$162.18	$213.80	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $4,073.80 / $8,709.64	Facility		$1,380.38	$4,073.80	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $275.42	Professional		$131.83	$177.83	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $141.25 / $141.25	Professional		$131.83	$141.25	$141.25