Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,884.03 / $6,918.31	Facility		$707.95	$2,884.03	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $1,348.96 / $2,290.87	Professional		$114.82	$1,348.96	$2,290.87
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Professional	50	$2,691.53	$2,691.53	$2,691.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,148.15 / $1,445.44	Professional		$1,000.00	$1,148.15	$1,445.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Professional	50	$1,698.24	$1,698.24	$1,698.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,548.82 / $5,888.44	Facility		$812.83	$1,548.82	$5,888.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $870.96 / $1,548.82	Professional		$107.15	$870.96	$1,548.82
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,621.81 / $2,041.74	Professional		$1,230.27	$1,621.81	$2,041.74
Christus Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $891.25 / $891.25	Facility		$104.71	$891.25	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility		$1,412.54	$1,412.54	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $288.40 / $2,511.89	Professional		$134.90	$288.40	$2,511.89
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $5,623.41	Facility		$54.95	$56.23	$5,623.41
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $8,709.64 / $10,232.93 / $10,232.93	Professional		$8,709.64	$10,232.93	$10,232.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $2,089.30 / $5,754.40	Facility		$181.97	$2,089.30	$5,754.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $1,318.26 / $2,290.87	Professional		$114.82	$1,318.26	$2,290.87
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $2,290.87 / $2,344.23 / $2,691.53	Professional	50	$2,290.87	$2,344.23	$2,691.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,023.29	Professional		$32.36	$33.11	$1,023.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $416.87 / $2,630.27	Professional		$117.49	$416.87	$2,630.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $1,122.02 / $2,511.89	Facility		$117.49	$1,122.02	$2,511.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $275.42 / $2,511.89	Professional		$131.83	$275.42	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,511.89 / $4,786.30	Facility		$724.44	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $933.25 / $2,398.83	Professional		$112.20	$933.25	$2,398.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,230.27 / $1,288.25	Professional		$1,230.27	$1,230.27	$1,288.25