Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $893.00 / $3,570.00 / $10,893.00	Facility		$893.00	$3,570.00	$10,893.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,303.81 / $1,777.09 / $5,886.41	Facility	50	$1,303.81	$1,777.09	$5,886.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.99 / $2,872.04 / $4,223.91	Professional		$246.99	$2,872.04	$4,223.91
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $4,221.70 / $5,615.42 / $18,000.00	Professional	50	$4,221.70	$5,615.42	$18,000.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $3,696.15 / $3,696.15 / $4,061.70	Professional	50	$3,696.15	$3,696.15	$4,061.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,839.01 / $3,526.36 / $14,754.00	Facility		$1,839.01	$3,526.36	$14,754.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.99 / $2,268.11 / $4,073.41	Professional		$203.99	$2,268.11	$4,073.41
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $349.90 / $3,306.32 / $3,926.31	Professional		$349.90	$3,306.32	$3,926.31
Christus Facility/Professional Facility Modifier Low / Median / High Price $212.34 / $7,298.21 / $7,298.21	Facility		$212.34	$7,298.21	$7,298.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,463.67 / $4,463.67 / $4,463.67	Facility		$4,463.67	$4,463.67	$4,463.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.94 / $2,924.42 / $6,311.05	Professional		$276.94	$2,924.42	$6,311.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,735.56 / $5,897.00 / $5,897.00	Facility		$1,735.56	$5,897.00	$5,897.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,142.77 / $21,145.72 / $24,951.75	Professional		$11,142.77	$21,145.72	$24,951.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $249.07 / $1,015.31 / $5,496.62	Facility		$249.07	$1,015.31	$5,496.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $321.27 / $3,142.89 / $5,142.91	Professional		$321.27	$3,142.89	$5,142.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $249.07 / $2,416.71 / $7,712.39	Facility		$249.07	$2,416.71	$7,712.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $281.39 / $3,019.53 / $6,747.86	Professional		$281.39	$3,019.53	$6,747.86
Providence Facility/Professional Professional Modifier AS Low / Median / High Price $802.12 / $970.99 / $1,207.76	Professional	AS	$802.12	$970.99	$1,207.76
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,425.00 / $10,600.00	Facility		$1,634.00	$4,425.00	$10,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,949.56 / $4,127.32 / $6,590.24	Professional		$2,949.56	$4,127.32	$6,590.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,438.51 / $2,707.80 / $3,881.33	Professional		$2,438.51	$2,707.80	$3,881.33