Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,060.26 / $4,007.00 / $9,516.48	Facility		$1,060.26	$4,007.00	$9,516.48
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $66.39 / $102.55 / $267.02	Facility	53	$66.39	$102.55	$267.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.93 / $744.16 / $1,354.00	Professional		$331.93	$744.16	$1,354.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $310.05 / $360.48 / $626.71	Professional		$310.05	$360.48	$626.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,442.89 / $4,350.91 / $8,369.27	Facility		$2,442.89	$4,350.91	$8,369.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $299.89 / $703.54 / $1,263.52	Professional		$299.89	$703.54	$1,263.52
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $168.30 / $1,270.95 / $4,050.00	Facility		$168.30	$1,270.95	$4,050.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $158.69 / $310.08 / $528.29	Professional		$158.69	$310.08	$528.29
Christus Facility/Professional Facility Modifier Low / Median / High Price $293.97 / $3,074.63 / $3,074.63	Facility		$293.97	$3,074.63	$3,074.63
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 $379.81 / $744.33 / $1,905.81	Professional		$379.81	$744.33	$1,905.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,858.50 / $26,542.00 / $26,542.00	Facility		$1,858.50	$26,542.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $297.92 / $319.74 / $319.74	Facility	53	$297.92	$319.74	$319.74
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $148.96 / $159.87 / $159.87	Facility	AS	$148.96	$159.87	$159.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,494.00 / $7,664.36 / $7,917.29	Professional		$5,494.00	$7,664.36	$7,917.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $362.76 / $1,014.38 / $2,338.69	Facility		$362.76	$1,014.38	$2,338.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $413.78 / $1,142.19 / $1,574.79	Professional		$413.78	$1,142.19	$1,574.79
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $853.48 / $2,499.00 / $8,151.00	Facility		$853.48	$2,499.00	$8,151.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $317.39 / $898.19 / $1,766.35	Professional		$317.39	$898.19	$1,766.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $362.76 / $990.55 / $2,334.23	Facility		$362.76	$990.55	$2,334.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $384.47 / $916.72 / $2,014.81	Professional		$384.47	$916.72	$2,014.81
United Facility/Professional Facility Modifier Low / Median / High Price $1,693.00 / $5,231.00 / $10,423.00	Facility		$1,693.00	$5,231.00	$10,423.00
United Facility/Professional Professional Modifier Low / Median / High Price $900.39 / $1,200.52 / $1,929.03	Professional		$900.39	$1,200.52	$1,929.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $768.02 / $860.36 / $1,219.13	Professional		$768.02	$860.36	$1,219.13