Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $352.50 / $1,520.00 / $5,293.38	Facility		$352.50	$1,520.00	$5,293.38
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $682.50 / $1,765.50 / $5,293.38	Facility	50	$682.50	$1,765.50	$5,293.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.99 / $132.87 / $291.08	Professional		$121.99	$132.87	$291.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $137.05 / $181.82	Professional		$129.19	$137.05	$181.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,845.00 / $2,866.00 / $4,277.00	Facility		$1,845.00	$2,866.00	$4,277.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.11 / $158.18 / $215.78	Professional		$124.11	$158.18	$215.78
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $131.25 / $2,600.00 / $8,000.00	Facility		$131.25	$2,600.00	$8,000.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $129.87 / $180.70 / $240.26	Professional		$129.87	$180.70	$240.26
Christus Facility/Professional Facility Modifier Low / Median / High Price $120.49 / $159.26 / $159.26	Facility		$120.49	$159.26	$159.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.35 / $187.16 / $289.95	Professional		$145.35	$187.16	$289.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $649.94	Facility		$55.00	$55.00	$649.94
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $30.46 / $62.22 / $64.98	Facility	AS	$30.46	$62.22	$64.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $964.32 / $987.52 / $1,171.50	Professional		$964.32	$987.52	$1,171.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.72 / $168.83 / $305.62	Facility		$128.72	$168.83	$305.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $148.10 / $203.40 / $247.27	Professional		$148.10	$203.40	$247.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $129.87 / $164.88 / $294.44	Professional		$129.87	$164.88	$294.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $129.47 / $170.15 / $312.83	Facility		$129.47	$170.15	$312.83
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $52.42 / $52.42 / $52.42	Facility	80	$52.42	$52.42	$52.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $44.56 / $44.56 / $44.56	Facility	AS	$44.56	$44.56	$44.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $145.35 / $190.53 / $300.20	Professional		$145.35	$190.53	$300.20
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $950.00 / $2,376.00	Facility		$157.00	$950.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $109.08 / $155.40 / $247.25	Professional		$109.08	$155.40	$247.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $113.46 / $129.87 / $177.82	Professional		$113.46	$129.87	$177.82