Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $442.40 / $1,791.00 / $5,216.00	Facility		$442.40	$1,791.00	$5,216.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $79.88 / $128.24 / $300.55	Facility	52	$79.88	$128.24	$300.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.75 / $299.17 / $673.62	Professional		$159.75	$299.17	$673.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $180.31 / $217.15	Professional		$77.72	$180.31	$217.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.24 / $1,233.89 / $2,664.27	Facility		$691.24	$1,233.89	$2,664.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.68 / $326.89 / $529.52	Professional		$150.68	$326.89	$529.52
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $212.50 / $805.42 / $1,274.51	Facility		$212.50	$805.42	$1,274.51
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $163.21 / $230.52 / $404.14	Professional		$163.21	$230.52	$404.14
Christus Facility/Professional Facility Modifier Low / Median / High Price $145.46 / $434.24 / $434.24	Facility		$145.46	$434.24	$434.24
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 $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.85 / $322.95 / $612.29	Professional		$185.85	$322.95	$612.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,120.56 / $11,500.00 / $16,394.00	Facility		$1,120.56	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $595.82 / $645.39 / $645.39	Facility	52	$595.82	$645.39	$645.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,528.93 / $2,916.88 / $3,408.38	Professional		$1,528.93	$2,916.88	$3,408.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $163.79 / $292.31 / $603.49	Facility		$163.79	$292.31	$603.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $175.05 / $296.00 / $701.52	Professional		$175.05	$296.00	$701.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $168.45 / $399.95 / $823.35	Professional		$168.45	$399.95	$823.35
Providence Facility/Professional Facility Modifier Low / Median / High Price $163.79 / $306.92 / $632.63	Facility		$163.79	$306.92	$632.63
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $192.72 / $389.60 / $803.23	Professional		$192.72	$389.60	$803.23
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 $191.63 / $376.31 / $623.00	Professional		$191.63	$376.31	$623.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $335.42 / $392.33 / $532.74	Professional		$335.42	$392.33	$532.74