Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $464.75 / $2,152.00 / $5,906.00	Facility		$464.75	$2,152.00	$5,906.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $85.02 / $136.34 / $277.54	Facility	52	$85.02	$136.34	$277.54
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.01 / $54.54 / $111.01	Facility	53	$34.01	$54.54	$111.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.03 / $283.07 / $550.52	Professional		$170.03	$283.07	$550.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.42 / $170.22 / $289.91	Professional		$107.42	$170.22	$289.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.61 / $1,233.89 / $2,664.27	Facility		$691.61	$1,233.89	$2,664.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.66 / $292.77 / $491.18	Professional		$158.66	$292.77	$491.18
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $497.17 / $981.00 / $2,489.37	Facility		$497.17	$981.00	$2,489.37
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $179.15 / $259.45 / $525.91	Professional		$179.15	$259.45	$525.91
Christus Facility/Professional Facility Modifier Low / Median / High Price $154.63 / $727.12 / $727.12	Facility		$154.63	$727.12	$727.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $544.67 / $722.59 / $2,213.00	Facility		$544.67	$722.59	$2,213.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.98 / $337.29 / $603.20	Professional		$197.98	$337.29	$603.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,190.22 / $11,500.00 / $16,394.00	Facility		$1,190.22	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $633.38 / $684.69 / $684.69	Facility	52	$633.38	$684.69	$684.69
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $158.34 / $171.17 / $171.17	Facility	53	$158.34	$171.17	$171.17
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,654.00 / $2,720.72 / $3,176.25	Professional		$1,654.00	$2,720.72	$3,176.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $174.45 / $307.64 / $610.58	Facility		$174.45	$307.64	$610.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $219.92 / $334.00 / $659.68	Professional		$219.92	$334.00	$659.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $176.04 / $366.76 / $769.20	Professional		$176.04	$366.76	$769.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $174.45 / $316.99 / $645.58	Facility		$174.45	$316.99	$645.58
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $204.74 / $392.60 / $758.35	Professional		$204.74	$392.60	$758.35
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 $203.89 / $372.42 / $613.02	Professional		$203.89	$372.42	$613.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $312.79 / $365.82 / $496.49	Professional		$312.79	$365.82	$496.49