Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.55 / $1,729.02 / $4,635.00	Facility		$360.55	$1,729.02	$4,635.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $59.09 / $152.82 / $1,234.95	Facility	52	$59.09	$152.82	$1,234.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $23.63 / $61.13 / $2,469.89	Facility	53	$23.63	$61.13	$2,469.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.17 / $236.99 / $483.65	Professional		$118.17	$236.99	$483.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.87 / $138.22 / $257.00	Professional		$74.87	$138.22	$257.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $699.47 / $1,233.89 / $2,664.27	Facility		$699.47	$1,233.89	$2,664.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.05 / $225.03 / $368.92	Professional		$110.05	$225.03	$368.92
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $266.39 / $805.42 / $2,297.12	Facility		$266.39	$805.42	$2,297.12
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $155.00 / $294.68	Professional		$86.40	$155.00	$294.68
Christus Facility/Professional Facility Modifier Low / Median / High Price $108.56 / $513.84 / $513.84	Facility		$108.56	$513.84	$513.84
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 $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.11 / $277.19 / $495.00	Professional		$141.11	$277.19	$495.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $830.82 / $11,500.00 / $12,000.00	Facility		$830.82	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $442.02 / $479.90 / $479.90	Facility	52	$442.02	$479.90	$479.90
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $110.50 / $119.98 / $119.98	Facility	53	$110.50	$119.98	$119.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,213.00 / $2,049.19 / $2,396.63	Professional		$1,213.00	$2,049.19	$2,396.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $123.96 / $285.86 / $499.68	Facility		$123.96	$285.86	$499.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.47 / $234.84 / $493.09	Professional		$138.47	$234.84	$493.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $927.38 / $2,499.00 / $3,730.00	Facility		$927.38	$2,499.00	$3,730.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.74 / $276.58 / $562.92	Professional		$117.74	$276.58	$562.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.96 / $290.05 / $531.29	Facility		$123.96	$290.05	$531.29
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $305.24 / $612.60	Professional		$145.00	$305.24	$612.60
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 $230.40 / $316.80 / $489.60	Professional		$230.40	$316.80	$489.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $235.76 / $275.73 / $374.37	Professional		$235.76	$275.73	$374.37