Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $2,818.38 / $8,317.64	Facility		$645.65	$2,818.38	$8,317.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,754.23 / $2,754.23 / $4,897.79	Facility	50	$2,754.23	$2,754.23	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $977.24	Professional		$389.05	$524.81	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $446.68 / $562.34	Professional		$204.17	$446.68	$562.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $4,677.35 / $9,120.11	Facility		$2,511.89	$4,677.35	$9,120.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $501.19 / $758.58	Professional		$389.05	$501.19	$758.58
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $4,168.69 / $7,413.10	Facility		$676.08	$4,168.69	$7,413.10
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $575.44 / $831.76	Professional		$446.68	$575.44	$831.76
Christus Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $3,981.07 / $3,981.07	Facility		$371.54	$3,981.07	$3,981.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility		$2,187.76	$2,187.76	$2,187.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $616.60 / $1,023.29	Professional		$446.68	$616.60	$1,023.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,709.64 / $28,840.32 / $28,840.32	Facility		$8,709.64	$28,840.32	$28,840.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,801.89 / $4,466.84 / $4,466.84	Professional		$3,801.89	$4,466.84	$4,466.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $707.95 / $4,265.80	Facility		$426.58	$707.95	$4,265.80
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,754.23 / $2,754.23 / $4,897.79	Facility	50	$2,754.23	$2,754.23	$4,897.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $562.34 / $1,023.29	Professional		$407.38	$562.34	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $354.81	Professional		$32.36	$33.11	$354.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $870.96 / $1,412.54	Professional		$416.87	$870.96	$1,412.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $575.44 / $1,071.52	Facility		$407.38	$575.44	$1,071.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $630.96 / $1,023.29	Professional		$446.68	$630.96	$1,023.29
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $4,073.80 / $8,709.64	Facility		$1,380.38	$4,073.80	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $812.83	Professional		$371.54	$524.81	$812.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $562.34 / $562.34	Professional		$524.81	$562.34	$562.34