Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $4,028.00 / $14,895.00	Facility		$975.00	$4,028.00	$14,895.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.02 / $183.66 / $822.83	Facility	52	$118.02	$183.66	$822.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.71 / $759.09 / $1,630.27	Professional		$227.71	$759.09	$1,630.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $118.02 / $513.65 / $815.14	Professional	52	$118.02	$513.65	$815.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.78 / $227.74 / $985.95	Professional		$221.78	$227.74	$985.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,755.75 / $7,827.18 / $15,531.00	Facility		$4,755.75	$7,827.18	$15,531.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.10 / $861.51 / $1,547.23	Professional		$211.10	$861.51	$1,547.23
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $230.97 / $6,103.06 / $16,103.32	Facility		$230.97	$6,103.06	$16,103.32
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $248.58 / $309.77 / $467.44	Professional		$248.58	$309.77	$467.44
Christus Facility/Professional Facility Modifier Low / Median / High Price $207.32 / $3,994.64 / $3,994.64	Facility		$207.32	$3,994.64	$3,994.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,774.66 / $3,774.66 / $3,774.66	Facility		$3,774.66	$3,774.66	$3,774.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.89 / $494.05 / $1,941.14	Professional		$264.89	$494.05	$1,941.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,918.66	Facility		$55.00	$55.00	$1,918.66
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $848.95 / $894.60 / $894.60	Facility	52	$848.95	$894.60	$894.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,299.66 / $8,227.04 / $9,699.60	Professional		$4,299.66	$8,227.04	$9,699.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $238.47 / $946.20 / $1,995.88	Facility		$238.47	$946.20	$1,995.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $294.77 / $1,446.95 / $1,947.82	Professional		$294.77	$1,446.95	$1,947.82
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $547.83 / $2,499.00 / $5,733.00	Facility		$547.83	$2,499.00	$5,733.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $238.47 / $1,060.17 / $2,173.04	Professional		$238.47	$1,060.17	$2,173.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $238.47 / $1,060.17 / $2,399.05	Facility		$238.47	$1,060.17	$2,399.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $267.14 / $709.25 / $2,133.30	Professional		$267.14	$709.25	$2,133.30
United Facility/Professional Facility Modifier Low / Median / High Price $2,605.00 / $7,123.00 / $16,000.00	Facility		$2,605.00	$7,123.00	$16,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,028.95 / $1,405.48 / $2,241.51	Professional		$1,028.95	$1,405.48	$2,241.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $949.95 / $1,060.17 / $1,509.93	Professional		$949.95	$1,060.17	$1,509.93