Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $3,388.44 / $8,709.64	Facility		$724.44	$3,388.44	$8,709.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $6,165.95 / $16,595.87	Facility	50	$1,380.38	$6,165.95	$16,595.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,096.48 / $2,511.89	Professional		$309.03	$1,096.48	$2,511.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $363.08 / $891.25 / $3,090.30	Professional	50	$363.08	$891.25	$3,090.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $316.23 / $501.19	Professional		$158.49	$316.23	$501.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $309.03 / $446.68 / $724.44	Professional	50	$309.03	$446.68	$724.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $7,079.46 / $13,803.84	Facility		$3,890.45	$7,079.46	$13,803.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $1,174.90 / $2,238.72	Professional		$302.00	$1,174.90	$2,238.72
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $2,187.76 / $3,981.07	Facility		$512.86	$2,187.76	$3,981.07
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $371.54 / $616.60	Professional		$199.53	$371.54	$616.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $5,370.32 / $5,370.32	Facility		$288.40	$5,370.32	$5,370.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $562.34 / $562.34	Facility		$562.34	$562.34	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $1,047.13 / $3,090.30	Professional		$354.81	$1,047.13	$3,090.30
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $14,454.40	Facility		$54.95	$56.23	$14,454.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,748.98 / $14,125.38 / $14,125.38	Professional		$11,748.98	$14,125.38	$14,125.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $1,698.24 / $3,890.45	Facility		$338.84	$1,698.24	$3,890.45
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,071.52 / $4,677.35 / $14,125.38	Facility	50	$1,071.52	$4,677.35	$14,125.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $1,288.25 / $3,388.44	Professional		$316.23	$1,288.25	$3,388.44
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $371.54 / $912.01 / $3,630.78	Professional	50	$371.54	$912.01	$3,630.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,380.38	Professional		$32.36	$33.11	$1,380.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $3,235.94 / $6,918.31	Professional		$338.84	$3,235.94	$6,918.31
Providence Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $1,380.38 / $3,162.28	Facility		$331.13	$1,380.38	$3,162.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $1,000.00 / $3,162.28	Professional		$363.08	$1,000.00	$3,162.28
United Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $8,317.64 / $17,378.01	Facility		$2,630.27	$8,317.64	$17,378.01
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $1,174.90 / $2,511.89	Professional		$309.03	$1,174.90	$2,511.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,905.46 / $2,290.87	Professional		$1,819.70	$1,905.46	$2,290.87