Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $535.73 / $678.18 / $4,161.30	Facility		$535.73	$678.18	$4,161.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $529.53 / $2,271.78 / $5,742.25	Professional		$529.53	$2,271.78	$5,742.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $205.51 / $269.75 / $435.68	Professional		$205.51	$269.75	$435.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,610.68 / $7,827.18 / $15,308.00	Facility		$4,610.68	$7,827.18	$15,308.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $394.96 / $2,090.67 / $3,754.76	Professional		$394.96	$2,090.67	$3,754.76
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $420.34 / $6,733.45 / $22,653.27	Facility		$420.34	$6,733.45	$22,653.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $361.91 / $478.29 / $864.14	Professional		$361.91	$478.29	$864.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $671.14 / $671.14 / $671.14	Professional		$671.14	$671.14	$671.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $5,066.78	Facility		$55.00	$55.00	$5,066.78
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $392.38 / $403.98 / $403.98	Facility	53	$392.38	$403.98	$403.98
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $196.19 / $201.99 / $201.99	Facility	AS	$196.19	$201.99	$201.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,001.13 / $19,731.41 / $23,221.95	Professional		$11,001.13	$19,731.41	$23,221.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $460.26 / $2,250.89 / $5,762.24	Facility		$460.26	$2,250.89	$5,762.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $411.02 / $1,768.50 / $2,114.44	Professional		$411.02	$1,768.50	$2,114.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $449.58 / $2,425.98 / $5,174.34	Professional		$449.58	$2,425.98	$5,174.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $449.58 / $2,250.89 / $6,523.37	Facility		$449.58	$2,250.89	$6,523.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $783.13 / $3,526.52 / $9,079.45	Professional		$783.13	$3,526.52	$9,079.45
United Facility/Professional Professional Modifier Low / Median / High Price $2,935.60 / $3,914.13 / $6,168.25	Professional		$2,935.60	$3,914.13	$6,168.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $2,264.31 / $2,522.00 / $3,596.99	Professional		$2,264.31	$2,522.00	$3,596.99