Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $624.00 / $2,496.00 / $7,495.00	Facility		$624.00	$2,496.00	$7,495.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,269.00 / $1,269.00 / $2,054.00	Facility	50	$1,269.00	$1,269.00	$2,054.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.30 / $515.26 / $813.96	Professional		$140.30	$515.26	$813.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.03 / $130.03 / $158.63	Professional		$130.03	$130.03	$158.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,845.00 / $2,866.00 / $4,277.00	Facility		$1,845.00	$2,866.00	$4,277.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.31 / $415.86 / $894.39	Professional		$125.31	$415.86	$894.39
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $65.02 / $85.32 / $113.78	Professional		$65.02	$85.32	$113.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $120.89 / $3,584.75 / $3,584.75	Facility		$120.89	$3,584.75	$3,584.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $235.63 / $235.63 / $235.63	Facility		$235.63	$235.63	$235.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.35 / $351.40 / $1,028.09	Professional		$159.35	$351.40	$1,028.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $938.28 / $1,053.11	Facility		$55.00	$938.28	$1,053.11
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,138.42 / $4,175.33 / $4,773.38	Professional		$2,138.42	$4,175.33	$4,773.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $140.87 / $436.74 / $1,009.88	Facility		$140.87	$436.74	$1,009.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $172.41 / $309.89 / $1,013.77	Professional		$172.41	$309.89	$1,013.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.29 / $524.01 / $1,493.40	Professional		$120.29	$524.01	$1,493.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $140.87 / $446.66 / $1,037.07	Facility		$140.87	$446.66	$1,037.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $167.70 / $386.65 / $1,262.21	Professional		$167.70	$386.65	$1,262.21
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $2,287.00	Facility		$161.00	$950.00	$2,287.00
United Facility/Professional Professional Modifier Low / Median / High Price $486.49 / $668.92 / $1,086.48	Professional		$486.49	$668.92	$1,086.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $465.18 / $519.77 / $737.86	Professional		$465.18	$519.77	$737.86