Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $2,511.89 / $6,760.83	Facility		$660.69	$2,511.89	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $371.54 / $977.24	Professional		$169.82	$371.54	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $954.99	Professional		$138.04	$194.98	$954.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,344.23 / $4,570.88	Facility		$1,230.27	$2,344.23	$4,570.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $457.09 / $724.44	Professional		$154.88	$457.09	$724.44
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $1,258.93 / $2,398.83	Facility		$223.87	$1,258.93	$2,398.83
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $426.58	Professional		$169.82	$239.88	$426.58
Christus Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,737.80 / $1,737.80	Facility		$158.49	$1,737.80	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $1,148.15 / $1,445.44	Facility		$295.12	$1,148.15	$1,445.44
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	52	$239.88	$239.88	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $354.81 / $977.24	Professional		$190.55	$354.81	$977.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,897.79 / $28,840.32 / $28,840.32	Facility		$4,897.79	$28,840.32	$28,840.32
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility	52	$3,890.45	$3,890.45	$3,890.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,897.79 / $4,897.79	Professional		$4,168.69	$4,897.79	$4,897.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $478.63 / $1,548.82	Facility		$173.78	$478.63	$1,548.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $407.38 / $1,071.52	Professional		$169.82	$407.38	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $501.19	Professional		$32.36	$33.11	$501.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $575.44 / $1,698.24	Professional		$263.03	$575.44	$1,698.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $346.74 / $1,000.00	Facility		$173.78	$346.74	$1,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $380.19 / $1,071.52	Professional		$186.21	$380.19	$1,071.52
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,511.89 / $4,786.30	Facility		$724.44	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $281.84 / $758.58	Professional		$158.49	$281.84	$758.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $630.96 / $707.95	Professional		$134.90	$630.96	$707.95