Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,196.00 / $3,483.14 / $12,281.00	Facility		$1,196.00	$3,483.14	$12,281.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $694.75 / $3,303.00 / $9,680.25	Facility	50	$694.75	$3,303.00	$9,680.25
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $686.07 / $703.65 / $1,102.90	Facility	52	$686.07	$703.65	$1,102.90
Aetna Facility/Professional Facility Modifier 62 Low / Median / High Price $5,967.75 / $5,967.75 / $5,967.75	Facility	62	$5,967.75	$5,967.75	$5,967.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,427.01 / $2,417.82 / $8,583.70	Facility		$1,427.01	$2,417.82	$8,583.70
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $137.50 / $1,158.84 / $4,000.00	Facility		$137.50	$1,158.84	$4,000.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,238.09 / $1,238.09 / $1,238.09	Facility		$1,238.09	$1,238.09	$1,238.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $11,584.72	Facility		$55.00	$55.00	$11,584.72
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,636.30 / $5,298.36 / $5,744.80	Facility	52	$2,636.30	$5,298.36	$5,744.80
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,059.61 / $4,139.34 / $4,488.13	Facility	62	$2,059.61	$4,139.34	$4,488.13
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $329.54 / $662.30 / $718.10	Facility	AS	$329.54	$662.30	$718.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,301.56 / $1,723.28 / $3,177.64	Facility		$1,301.56	$1,723.28	$3,177.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,301.56 / $1,773.86 / $3,258.80	Facility		$1,301.56	$1,773.86	$3,258.80
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,152.04 / $2,152.04 / $2,152.04	Facility	62	$2,152.04	$2,152.04	$2,152.04
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $550.91 / $550.91 / $550.91	Facility	80	$550.91	$550.91	$550.91
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $468.28 / $468.28 / $468.28	Facility	AS	$468.28	$468.28	$468.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,314.00 / $7,600.00	Facility		$1,154.00	$3,314.00	$7,600.00