Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $581.15 / $2,444.00 / $6,246.00	Facility		$581.15	$2,444.00	$6,246.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $95.72 / $101.47 / $150.16	Facility	52	$95.72	$101.47	$150.16
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.29 / $40.59 / $60.07	Facility	53	$38.29	$40.59	$60.07
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
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $147.18 / $820.18 / $4,500.00	Facility		$147.18	$820.18	$4,500.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $175.23 / $1,393.21 / $1,393.21	Facility		$175.23	$1,393.21	$1,393.21
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 $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,901.45 / $11,500.00 / $16,394.00	Facility		$4,901.45	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $358.02 / $3,716.72 / $3,716.72	Facility	52	$358.02	$3,716.72	$3,716.72
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $89.50 / $929.18 / $929.18	Facility	53	$89.50	$929.18	$929.18
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $279.70 / $2,903.69 / $2,903.69	Facility	62	$279.70	$2,903.69	$2,903.69
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $44.75 / $464.59 / $464.59	Facility	AS	$44.75	$464.59	$464.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $191.63 / $284.99 / $503.63	Facility		$191.63	$284.99	$503.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $192.48 / $288.57 / $543.38	Facility		$192.48	$288.57	$543.38
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $294.60 / $294.60	Facility	62	$137.94	$294.60	$294.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $75.42 / $75.42 / $75.42	Facility	80	$75.42	$75.42	$75.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $64.09 / $64.09	Facility	AS	$22.07	$64.09	$64.09
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