Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $280.50 / $1,964.00 / $6,386.00	Facility		$280.50	$1,964.00	$6,386.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $42.06 / $68.09 / $190.11	Facility	52	$42.06	$68.09	$190.11
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.82 / $27.24 / $76.04	Facility	53	$16.82	$27.24	$76.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.45 / $192.56 / $354.36	Professional		$84.45	$192.56	$354.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.67 / $82.54 / $122.01	Professional		$77.67	$82.54	$122.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $684.85 / $1,241.75 / $2,771.00	Facility		$684.85	$1,241.75	$2,771.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.13 / $209.34 / $339.10	Professional		$80.13	$209.34	$339.10
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $84.48 / $525.25 / $1,340.37	Facility		$84.48	$525.25	$1,340.37
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $82.54 / $109.88 / $173.78	Professional		$82.54	$109.88	$173.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $562.92 / $562.92	Facility		$77.84	$562.92	$562.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $544.67 / $722.59 / $1,652.00	Facility		$544.67	$722.59	$1,652.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.54 / $224.05 / $426.31	Professional		$100.54	$224.05	$426.31
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $595.14 / $11,500.00 / $12,000.00	Facility		$595.14	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $342.02 / $344.97 / $344.97	Facility	52	$342.02	$344.97	$344.97
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $85.51 / $86.24 / $86.24	Facility	53	$85.51	$86.24	$86.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,213.00 / $1,863.52 / $2,193.75	Professional		$1,213.00	$1,863.52	$2,193.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $88.99 / $238.74 / $410.17	Facility		$88.99	$238.74	$410.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $110.18 / $289.77 / $453.56	Professional		$110.18	$289.77	$453.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.67 / $354.99 / $602.51	Professional		$120.67	$354.99	$602.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $88.99 / $239.01 / $432.85	Facility		$88.99	$239.01	$432.85
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.77 / $240.46 / $515.00	Professional		$103.77	$240.46	$515.00
United Facility/Professional Facility Modifier Low / Median / High Price $593.00 / $2,045.00 / $4,480.00	Facility		$593.00	$2,045.00	$4,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.10 / $258.11 / $415.70	Professional		$191.10	$258.11	$415.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $215.06 / $251.42 / $341.60	Professional		$215.06	$251.42	$341.60