Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $437.00 / $1,934.00 / $6,386.00	Facility		$437.00	$1,934.00	$6,386.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,622.60 / $2,417.69 / $4,577.75	Facility	50	$1,622.60	$2,417.69	$4,577.75
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $54.66 / $84.22 / $220.95	Facility	52	$54.66	$84.22	$220.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.86 / $33.69 / $88.38	Facility	53	$21.86	$33.69	$88.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.40 / $262.62 / $594.54	Professional		$106.40	$262.62	$594.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.90 / $102.09 / $331.78	Professional		$92.90	$102.09	$331.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $561.15 / $1,002.51 / $2,143.73	Facility		$561.15	$1,002.51	$2,143.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.08 / $231.56 / $404.86	Professional		$97.08	$231.56	$404.86
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $580.53 / $812.74 / $3,892.49	Facility		$580.53	$812.74	$3,892.49
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $72.89 / $135.16 / $172.14	Professional		$72.89	$135.16	$172.14
Christus Facility/Professional Facility Modifier Low / Median / High Price $92.96 / $330.50 / $330.50	Facility		$92.96	$330.50	$330.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $477.01 / $477.01 / $477.01	Facility		$477.01	$477.01	$477.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.89 / $242.73 / $887.66	Professional		$123.89	$242.73	$887.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $611.65	Facility		$55.00	$55.00	$611.65
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $388.74 / $415.68 / $415.68	Facility	52	$388.74	$415.68	$415.68
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $97.18 / $103.92 / $103.92	Facility	53	$97.18	$103.92	$103.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,853.05 / $2,804.09 / $2,888.22	Professional		$1,853.05	$2,804.09	$2,888.22
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $107.71 / $296.97 / $641.54	Facility		$107.71	$296.97	$641.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $326.99 / $535.07	Professional		$134.97	$326.99	$535.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $240.30 / $240.30 / $240.30	Professional		$240.30	$240.30	$240.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.71 / $298.76 / $648.94	Facility		$107.71	$298.76	$648.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.77 / $266.95 / $867.95	Professional		$127.77	$266.95	$867.95
United Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $1,529.00 / $3,400.00	Facility		$369.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $255.51 / $404.83 / $947.60	Professional		$255.51	$404.83	$947.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $253.70 / $284.88 / $403.33	Professional		$253.70	$284.88	$403.33