Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $451.25 / $1,915.00 / $5,906.00	Facility		$451.25	$1,915.00	$5,906.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $658.00 / $1,184.00 / $3,589.22	Facility	50	$658.00	$1,184.00	$3,589.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.06 / $171.10 / $247.11	Professional		$143.06	$171.10	$247.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.67 / $98.81 / $147.33	Professional	50	$38.67	$98.81	$147.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $75.45 / $75.45	Professional		$75.45	$75.45	$75.45
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $113.19 / $113.19 / $113.19	Professional	50	$113.19	$113.19	$113.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,273.24 / $2,260.36 / $4,849.77	Facility		$1,273.24	$2,260.36	$4,849.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.05 / $179.03 / $251.12	Professional		$143.05	$179.03	$251.12
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $147.18 / $633.71 / $2,033.70	Facility		$147.18	$633.71	$2,033.70
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $109.42 / $109.42 / $109.42	Professional		$109.42	$109.42	$109.42
Christus Facility/Professional Facility Modifier Low / Median / High Price $134.07 / $134.07 / $134.07	Facility		$134.07	$134.07	$134.07
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 $163.00 / $214.58 / $337.37	Professional		$163.00	$214.58	$337.37
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,194.52 / $16,394.00 / $16,394.00	Facility		$5,194.52	$16,394.00	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,496.46 / $2,496.46 / $2,496.46	Professional		$2,496.46	$2,496.46	$2,496.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $156.52 / $215.09 / $445.91	Facility		$156.52	$215.09	$445.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $201.42 / $237.06 / $278.89	Professional		$201.42	$237.06	$278.89
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $204.41 / $204.41 / $204.41	Professional	50	$204.41	$204.41	$204.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.30 / $251.30 / $251.30	Professional		$251.30	$251.30	$251.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $156.52 / $218.78 / $445.91	Facility		$156.52	$218.78	$445.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $164.88 / $218.72 / $350.00	Professional		$164.88	$218.72	$350.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,314.00 / $7,600.00	Facility		$1,154.00	$3,314.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $181.80 / $297.37	Professional		$131.25	$181.80	$297.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $132.24 / $150.91 / $208.87	Professional		$132.24	$150.91	$208.87