Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $2,238.72 / $6,918.31	Facility		$537.03	$2,238.72	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,698.24 / $4,168.69 / $4,570.88	Facility	50	$1,698.24	$4,168.69	$4,570.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $245.47 / $676.08	Professional		$102.33	$245.47	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $218.78	Professional		$91.20	$102.33	$218.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,047.13 / $2,137.96	Facility		$602.56	$1,047.13	$2,137.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $223.87 / $389.05	Professional		$87.10	$223.87	$389.05
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $870.96 / $5,011.87	Facility		$537.03	$870.96	$5,011.87
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $114.82 / $338.84	Professional		$60.26	$114.82	$338.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $416.87 / $416.87	Facility		$93.33	$416.87	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $263.03 / $776.25	Professional		$123.03	$263.03	$776.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $1,905.46	Facility		$54.95	$56.23	$1,905.46
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	52	$1,513.56	$1,513.56	$1,513.56
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $380.19 / $380.19 / $380.19	Facility	53	$380.19	$380.19	$380.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Professional		$2,884.03	$2,884.03	$2,884.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $616.60 / $4,168.69	Facility		$123.03	$616.60	$4,168.69
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $4,168.69 / $4,168.69 / $4,570.88	Facility	50	$4,168.69	$4,168.69	$4,570.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $302.00 / $616.60	Professional		$107.15	$302.00	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $89.13	Professional		$32.36	$33.11	$89.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $870.96 / $1,621.81	Professional		$3.98	$870.96	$1,621.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $281.84 / $645.65	Facility		$107.15	$281.84	$645.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $263.03 / $776.25	Professional		$120.23	$263.03	$776.25
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,698.24 / $4,168.69	Facility		$436.52	$1,698.24	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $229.09 / $794.33	Professional		$104.71	$229.09	$794.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $316.23 / $316.23	Professional		$295.12	$316.23	$316.23