Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $353.72 / $2,500.00 / $11,752.14	Facility		$353.72	$2,500.00	$11,752.14
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $41.93 / $65.30 / $140.72	Facility	52	$41.93	$65.30	$140.72
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.77 / $26.12 / $56.29	Facility	53	$16.77	$26.12	$56.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.79 / $200.02 / $293.51	Professional		$84.79	$200.02	$293.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.55 / $79.15 / $257.23	Professional		$60.55	$79.15	$257.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,081.27 / $2,446.69 / $4,501.92	Facility		$1,081.27	$2,446.69	$4,501.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $156.40 / $273.07	Professional		$75.00	$156.40	$273.07
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $2,955.44 / $5,319.79	Facility		$82.00	$2,955.44	$5,319.79
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $80.41 / $124.27 / $350.15	Professional		$80.41	$124.27	$350.15
Christus Facility/Professional Facility Modifier Low / Median / High Price $76.48 / $83.43 / $83.43	Facility		$76.48	$83.43	$83.43
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 $100.68 / $215.29 / $387.58	Professional		$100.68	$215.29	$387.58
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $471.85 / $12,000.00 / $12,000.00	Facility		$471.85	$12,000.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $301.54 / $319.13 / $319.13	Facility	52	$301.54	$319.13	$319.13
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $75.39 / $79.78 / $79.78	Facility	53	$75.39	$79.78	$79.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,374.00 / $1,989.58 / $1,989.58	Professional		$1,374.00	$1,989.58	$1,989.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $92.13 / $226.01 / $457.64	Facility		$92.13	$226.01	$457.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.70 / $261.56 / $362.16	Professional		$104.70	$261.56	$362.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $80.75 / $201.90 / $407.70	Professional		$80.75	$201.90	$407.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.13 / $226.95 / $481.50	Facility		$92.13	$226.95	$481.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.73 / $221.93 / $402.66	Professional		$101.73	$221.93	$402.66
United Facility/Professional Facility Modifier Low / Median / High Price $365.00 / $1,529.00 / $5,925.00	Facility		$365.00	$1,529.00	$5,925.00
United Facility/Professional Professional Modifier Low / Median / High Price $182.68 / $241.36 / $384.54	Professional		$182.68	$241.36	$384.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $171.72 / $193.16 / $272.57	Professional		$171.72	$193.16	$272.57