Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $629.50 / $2,476.00 / $8,450.00	Facility		$629.50	$2,476.00	$8,450.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $619.00 / $1,534.44 / $6,334.40	Facility	50	$619.00	$1,534.44	$6,334.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.89 / $291.45 / $431.23	Professional		$240.89	$291.45	$431.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $175.06 / $263.70 / $533.02	Professional	50	$175.06	$263.70	$533.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.24 / $148.16 / $250.49	Professional		$125.24	$148.16	$250.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $187.87 / $187.87 / $187.87	Professional	50	$187.87	$187.87	$187.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,891.34 / $8,214.94 / $15,831.45	Facility		$3,891.34	$8,214.94	$15,831.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.02 / $298.64 / $418.88	Professional		$237.02	$298.64	$418.88
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $121.75 / $861.58 / $3,335.53	Facility		$121.75	$861.58	$3,335.53
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $181.61 / $181.61 / $363.21	Professional		$181.61	$181.61	$363.21
Christus Facility/Professional Facility Modifier Low / Median / High Price $220.54 / $5,972.19 / $5,972.19	Facility		$220.54	$5,972.19	$5,972.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,482.15 / $3,482.15 / $3,482.15	Facility		$3,482.15	$3,482.15	$3,482.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.14 / $371.88 / $606.86	Professional		$277.14	$371.88	$606.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $11,500.00 / $26,542.00 / $26,542.00	Facility		$11,500.00	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,305.00 / $5,305.00 / $5,305.00	Professional		$5,305.00	$5,305.00	$5,305.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $262.49 / $428.65 / $884.88	Facility		$262.49	$428.65	$884.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $333.46 / $392.46 / $461.72	Professional		$333.46	$392.46	$461.72
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,048.42 / $2,782.61 / $7,842.00	Facility		$2,048.42	$2,782.61	$7,842.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $509.30 / $509.30 / $509.30	Professional		$509.30	$509.30	$509.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $262.49 / $432.33 / $868.89	Facility		$262.49	$432.33	$868.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $281.13 / $384.53 / $660.71	Professional		$281.13	$384.53	$660.71
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 $233.44 / $321.76 / $510.29	Professional		$233.44	$321.76	$510.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.92 / $250.49 / $345.72	Professional		$218.92	$250.49	$345.72