Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $625.00 / $2,396.00 / $7,339.00	Facility		$625.00	$2,396.00	$7,339.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,250.00 / $2,417.57 / $7,323.00	Facility	50	$1,250.00	$2,417.57	$7,323.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.81 / $1,260.02 / $2,234.05	Professional		$297.81	$1,260.02	$2,234.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,332.66 / $4,673.00 / $6,015.33	Professional	50	$2,332.66	$4,673.00	$6,015.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.32 / $276.64 / $663.93	Professional		$138.32	$276.64	$663.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $192.95 / $926.83 / $1,134.61	Professional	50	$192.95	$926.83	$1,134.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,845.00 / $3,017.00 / $4,503.00	Facility		$1,845.00	$3,017.00	$4,503.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $265.95 / $933.60 / $1,933.63	Professional		$265.95	$933.60	$1,933.63
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $2,413.35 / $8,000.00	Facility		$200.00	$2,413.35	$8,000.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $280.33 / $442.62 / $1,996.91	Professional		$280.33	$442.62	$1,996.91
Christus Facility/Professional Facility Modifier Low / Median / High Price $255.44 / $552.51 / $552.51	Facility		$255.44	$552.51	$552.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.98 / $500.98 / $500.98	Facility		$500.98	$500.98	$500.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.25 / $765.96 / $2,787.00	Professional		$335.25	$765.96	$2,787.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,968.54 / $2,500.38 / $8,980.00	Facility		$1,968.54	$2,500.38	$8,980.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,077.16 / $11,617.10 / $11,965.62	Professional		$5,077.16	$11,617.10	$11,965.62
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $297.81 / $946.94 / $2,812.17	Facility		$297.81	$946.94	$2,812.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $366.26 / $903.52 / $2,436.06	Professional		$366.26	$903.52	$2,436.06
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,899.10 / $1,899.10 / $1,899.10	Professional	50	$1,899.10	$1,899.10	$1,899.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $276.64 / $1,071.75 / $2,617.42	Professional		$276.64	$1,071.75	$2,617.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $299.30 / $950.33 / $2,835.34	Facility		$299.30	$950.33	$2,835.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $357.28 / $896.10 / $3,140.90	Professional		$357.28	$896.10	$3,140.90
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 $1,248.11 / $1,768.11 / $2,882.51	Professional		$1,248.11	$1,768.11	$2,882.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,117.80 / $1,248.07 / $1,775.93	Professional		$1,117.80	$1,248.07	$1,775.93