Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $651.00 / $2,868.00 / $8,883.00	Facility		$651.00	$2,868.00	$8,883.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,076.00 / $2,253.98 / $5,886.41	Facility	50	$1,076.00	$2,253.98	$5,886.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.40 / $1,524.38 / $2,238.71	Professional		$156.40	$1,524.38	$2,238.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $384.83 / $2,066.79 / $4,629.77	Professional	50	$384.83	$2,066.79	$4,629.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $721.43 / $721.43 / $1,442.86	Professional		$721.43	$721.43	$1,442.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $984.75 / $984.75 / $2,164.29	Professional	50	$984.75	$984.75	$2,164.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,639.30 / $2,768.59 / $7,886.84	Facility		$1,639.30	$2,768.59	$7,886.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.55 / $1,204.74 / $2,166.78	Professional		$125.55	$1,204.74	$2,166.78
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $537.22 / $1,425.20 / $4,357.68	Facility		$537.22	$1,425.20	$4,357.68
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $108.43 / $1,760.96 / $2,092.15	Professional		$108.43	$1,760.96	$2,092.15
Christus Facility/Professional Facility Modifier Low / Median / High Price $132.60 / $1,946.16 / $1,946.16	Facility		$132.60	$1,946.16	$1,946.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,413.50 / $4,413.50 / $4,413.50	Facility		$4,413.50	$4,413.50	$4,413.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.56 / $541.91 / $3,439.61	Professional		$173.56	$541.91	$3,439.61
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,076.76 / $5,897.00 / $5,897.00	Facility		$1,076.76	$5,897.00	$5,897.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,092.23 / $11,235.92 / $13,289.25	Professional		$6,092.23	$11,235.92	$13,289.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $159.86 / $629.23 / $3,267.54	Facility		$159.86	$629.23	$3,267.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $199.32 / $1,674.09 / $2,739.42	Professional		$199.32	$1,674.09	$2,739.42
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $2,055.34 / $2,055.34 / $2,055.34	Professional	50	$2,055.34	$2,055.34	$2,055.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $315.80 / $315.80 / $315.80	Professional		$315.80	$315.80	$315.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $159.86 / $1,287.75 / $3,669.68	Facility		$159.86	$1,287.75	$3,669.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $177.48 / $1,026.81 / $3,573.49	Professional		$177.48	$1,026.81	$3,573.49
Providence Facility/Professional Professional Modifier 80 Low / Median / High Price $500.91 / $593.53 / $759.86	Professional	80	$500.91	$593.53	$759.86
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $425.78 / $504.50 / $645.88	Professional	AS	$425.78	$504.50	$645.88
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,345.00 / $10,600.00	Facility		$1,634.00	$4,345.00	$10,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,567.43 / $2,205.35 / $3,423.93	Professional		$1,567.43	$2,205.35	$3,423.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,298.90 / $1,442.86 / $2,067.21	Professional		$1,298.90	$1,442.86	$2,067.21