Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $3,467.37 / $11,481.54	Facility		$891.25	$3,467.37	$11,481.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Facility	50	$9,332.54	$9,332.54	$9,332.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $2,187.76 / $5,128.61	Professional		$309.03	$2,187.76	$5,128.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $501.19 / $501.19 / $870.96	Professional	50	$501.19	$501.19	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $281.84 / $3,090.30	Professional		$177.83	$281.84	$3,090.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,549.93 / $16,218.10 / $33,113.11	Facility		$9,549.93	$16,218.10	$33,113.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $2,290.87 / $4,265.80	Professional		$275.42	$2,290.87	$4,265.80
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $4,786.30 / $5,128.61 / $5,754.40	Professional		$4,786.30	$5,128.61	$5,754.40
Christus Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $9,120.11 / $9,120.11	Facility		$269.15	$9,120.11	$9,120.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $10,232.93 / $10,232.93 / $10,232.93	Facility		$10,232.93	$10,232.93	$10,232.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $758.58 / $6,606.93	Professional		$338.84	$758.58	$6,606.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $40,738.03	Facility		$54.95	$56.23	$40,738.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $23,442.29 / $27,542.29 / $27,542.29	Professional		$23,442.29	$27,542.29	$27,542.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $3,162.28 / $8,511.38	Facility		$478.63	$3,162.28	$8,511.38
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Facility	50	$9,332.54	$9,332.54	$9,332.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $3,467.37 / $6,025.60	Professional		$309.03	$3,467.37	$6,025.60
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $501.19 / $870.96 / $2,238.72	Professional	50	$501.19	$870.96	$2,238.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $251.19	Professional		$32.36	$33.11	$251.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $1,071.52 / $12,022.64	Professional		$269.15	$1,071.52	$12,022.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $3,090.30 / $7,079.46	Facility		$316.23	$3,090.30	$7,079.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $758.58 / $6,456.54	Professional		$331.13	$758.58	$6,456.54
United Facility/Professional Facility Modifier Low / Median / High Price $4,365.16 / $10,715.19 / $30,199.52	Facility		$4,365.16	$10,715.19	$30,199.52
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $2,344.23 / $5,754.40	Professional		$288.40	$2,344.23	$5,754.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $3,090.30 / $3,090.30 / $3,235.94	Professional		$3,090.30	$3,090.30	$3,235.94