Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,659.59 / $5,248.07	Facility		$398.11	$1,659.59	$5,248.07
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $676.08 / $1,479.11 / $5,248.07	Facility	50	$676.08	$1,479.11	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $165.96 / $467.74	Professional		$123.03	$165.96	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $138.04 / $181.97	Professional		$120.23	$138.04	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $2,630.27 / $4,265.80	Facility		$1,023.29	$2,630.27	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $208.93	Professional		$120.23	$151.36	$208.93
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $2,570.40 / $5,754.40	Facility		$131.83	$2,570.40	$5,754.40
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $234.42	Professional		$131.83	$181.97	$234.42
Christus Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $158.49 / $158.49	Facility		$120.23	$158.49	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $295.12	Professional		$141.25	$186.21	$295.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $851.14	Facility		$54.95	$56.23	$851.14
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $85.11 / $85.11 / $85.11	Facility	AS	$85.11	$85.11	$85.11
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,174.90 / $1,174.90	Professional		$954.99	$1,174.90	$1,174.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $776.25 / $4,168.69	Facility		$134.90	$776.25	$4,168.69
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $758.58 / $1,621.81 / $5,248.07	Facility	50	$758.58	$1,621.81	$5,248.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $331.13	Professional		$125.89	$186.21	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $269.15 / $446.68	Professional		$138.04	$269.15	$446.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $162.18 / $295.12	Facility		$125.89	$162.18	$295.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $281.84	Professional		$141.25	$186.21	$281.84
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,047.13 / $2,691.53	Facility		$154.88	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $245.47	Professional		$114.82	$158.49	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $151.36 / $151.36	Professional		$141.25	$151.36	$151.36