Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $767.00 / $3,174.00 / $9,829.21	Facility		$767.00	$3,174.00	$9,829.21
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,924.40 / $3,840.09 / $7,609.00	Facility	50	$2,924.40	$3,840.09	$7,609.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $283.43 / $1,119.22 / $1,558.18	Professional		$283.43	$1,119.22	$1,558.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,056.46 / $3,741.19 / $3,741.19	Professional	50	$2,056.46	$3,741.19	$3,741.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $338.08 / $944.38 / $1,211.71	Professional		$338.08	$944.38	$1,211.71
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $360.54 / $507.11 / $1,408.62	Professional	50	$360.54	$507.11	$1,408.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,492.73 / $4,335.25 / $8,427.00	Facility		$2,492.73	$4,335.25	$8,427.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.54 / $884.01 / $1,528.36	Professional		$251.54	$884.01	$1,528.36
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $1,086.04 / $1,416.57 / $1,699.88	Professional		$1,086.04	$1,416.57	$1,699.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $242.17 / $2,012.09 / $2,012.09	Facility		$242.17	$2,012.09	$2,012.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,280.46 / $2,280.46 / $2,280.46	Facility		$2,280.46	$2,280.46	$2,280.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.79 / $1,133.26 / $2,936.16	Professional		$318.79	$1,133.26	$2,936.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,830.90 / $26,542.00 / $26,542.00	Facility		$1,830.90	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $9,157.00 / $12,119.05 / $12,518.98	Professional		$9,157.00	$12,119.05	$12,518.98
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $297.33 / $1,060.25 / $3,101.18	Facility		$297.33	$1,060.25	$3,101.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $343.14 / $1,286.74 / $2,940.27	Professional		$343.14	$1,286.74	$2,940.27
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,924.23 / $1,925.55 / $2,886.35	Professional	50	$1,924.23	$1,925.55	$2,886.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $262.08 / $977.36 / $1,933.92	Professional		$262.08	$977.36	$1,933.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $297.33 / $1,110.74 / $3,175.12	Facility		$297.33	$1,110.74	$3,175.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $325.91 / $1,227.05 / $2,999.19	Professional		$325.91	$1,227.05	$2,999.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,693.00 / $5,231.00 / $10,476.00	Facility		$1,693.00	$5,231.00	$10,476.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,123.98 / $1,687.37 / $2,694.06	Professional		$1,123.98	$1,687.37	$2,694.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $844.76 / $944.38 / $1,339.98	Professional		$844.76	$944.38	$1,339.98