Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $1,995.26 / $6,918.31	Facility		$426.58	$1,995.26	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $245.47 / $1,584.89 / $5,888.44	Facility	50	$245.47	$1,584.89	$5,888.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $478.63 / $1,288.25	Professional		$169.82	$478.63	$1,288.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $218.78 / $5,888.44	Professional	50	$123.03	$218.78	$5,888.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $154.88 / $741.31	Professional		$81.28	$154.88	$741.31
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $512.86 / $512.86 / $1,122.02	Professional	50	$512.86	$512.86	$1,122.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $4,365.16 / $9,549.93	Facility		$1,023.29	$4,365.16	$9,549.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $562.34 / $1,096.48	Professional		$154.88	$562.34	$1,096.48
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $1,122.02 / $8,511.38	Facility		$125.89	$1,122.02	$8,511.38
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $891.25 / $1,122.02	Professional		$741.31	$891.25	$1,122.02
Christus Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $537.03 / $537.03	Facility		$151.36	$537.03	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $407.38 / $1,445.44	Professional		$194.98	$407.38	$1,445.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $8,709.64	Facility		$54.95	$56.23	$8,709.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,754.40 / $6,760.83 / $6,760.83	Professional		$5,754.40	$6,760.83	$6,760.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $1,023.29 / $4,073.80	Facility		$204.17	$1,023.29	$4,073.80
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $245.47 / $3,890.45 / $12,589.25	Facility	50	$245.47	$3,890.45	$12,589.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $724.44 / $1,445.44	Professional		$177.83	$724.44	$1,445.44
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $870.96 / $5,888.44	Professional	50	$123.03	$870.96	$5,888.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $645.65	Professional		$32.36	$33.11	$645.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $602.56 / $2,951.21	Professional		$151.36	$602.56	$2,951.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $630.96 / $1,621.81	Facility		$186.21	$630.96	$1,621.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $407.38 / $1,445.44	Professional		$186.21	$407.38	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,047.13 / $2,691.53	Facility		$154.88	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $575.44 / $1,258.93	Professional		$158.49	$575.44	$1,258.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $812.83	Professional		$776.25	$776.25	$812.83