Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $604.83 / $2,229.00 / $6,000.00	Facility		$604.83	$2,229.00	$6,000.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.18 / $136.53 / $425.83	Facility	52	$84.18	$136.53	$425.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.25 / $296.23 / $814.47	Professional		$168.25	$296.23	$814.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.77 / $161.32 / $215.13	Professional		$92.77	$161.32	$215.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,199.20 / $2,336.10 / $4,656.63	Facility		$1,199.20	$2,336.10	$4,656.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.74 / $425.54 / $764.24	Professional		$157.74	$425.54	$764.24
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $545.00 / $1,538.19 / $3,185.96	Facility		$545.00	$1,538.19	$3,185.96
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $173.76 / $239.96 / $380.48	Professional		$173.76	$239.96	$380.48
Christus Facility/Professional Facility Modifier Low / Median / High Price $154.21 / $1,761.79 / $1,761.79	Facility		$154.21	$1,761.79	$1,761.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $935.02 / $1,240.44 / $2,213.00	Facility		$935.02	$1,240.44	$2,213.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.38 / $342.72 / $887.76	Professional		$196.38	$342.72	$887.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,188.72 / $11,500.00 / $16,394.00	Facility		$1,188.72	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $634.61 / $682.37 / $682.37	Facility	52	$634.61	$682.37	$682.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,166.58 / $4,122.24 / $4,857.08	Professional		$2,166.58	$4,122.24	$4,857.08
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $172.79 / $306.87 / $861.95	Facility		$172.79	$306.87	$861.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $198.82 / $410.71 / $995.41	Professional		$198.82	$410.71	$995.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $179.04 / $559.98 / $1,176.65	Professional		$179.04	$559.98	$1,176.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $172.79 / $327.36 / $904.24	Facility		$172.79	$327.36	$904.24
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $203.86 / $425.00 / $1,187.27	Professional		$203.86	$425.00	$1,187.27
United Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $2,045.00 / $4,475.00	Facility		$597.00	$2,045.00	$4,475.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.29 / $568.98 / $957.39	Professional		$191.29	$568.98	$957.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $475.94 / $556.37 / $755.97	Professional		$475.94	$556.37	$755.97