Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $559.75 / $1,918.50 / $5,016.00	Facility		$559.75	$1,918.50	$5,016.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $73.84 / $118.56 / $752.98	Facility	52	$73.84	$118.56	$752.98
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.54 / $47.42 / $301.19	Facility	53	$29.54	$47.42	$301.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $273.02 / $1,411.18	Professional		$147.13	$273.02	$1,411.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.59 / $152.33 / $261.14	Professional		$84.59	$152.33	$261.14
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 $137.87 / $762.94 / $1,393.02	Professional		$137.87	$762.94	$1,393.02
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $483.00 / $1,512.26 / $3,432.54	Facility		$483.00	$1,512.26	$3,432.54
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $84.50 / $165.27 / $301.95	Professional		$84.50	$165.27	$301.95
Christus Facility/Professional Facility Modifier Low / Median / High Price $133.96 / $1,438.71 / $1,438.71	Facility		$133.96	$1,438.71	$1,438.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $865.00 / $1,240.44 / $2,213.00	Facility		$865.00	$1,240.44	$2,213.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.45 / $303.14 / $1,638.22	Professional		$172.45	$303.14	$1,638.22
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,035.78 / $11,500.00 / $16,394.00	Facility		$1,035.78	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $551.04 / $596.83 / $596.83	Facility	52	$551.04	$596.83	$596.83
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $137.76 / $149.21 / $149.21	Facility	53	$137.76	$149.21	$149.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,836.03 / $7,375.25 / $8,642.10	Professional		$3,836.03	$7,375.25	$8,642.10
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $151.41 / $269.58 / $1,529.17	Facility		$151.41	$269.58	$1,529.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $143.71 / $250.21 / $1,734.43	Professional		$143.71	$250.21	$1,734.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $155.22 / $562.82 / $2,119.77	Professional		$155.22	$562.82	$2,119.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.41 / $284.45 / $1,594.33	Facility		$151.41	$284.45	$1,594.33
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $178.23 / $378.84 / $2,173.54	Professional		$178.23	$378.84	$2,173.54
United Facility/Professional Facility Modifier Low / Median / High Price $593.00 / $2,045.00 / $4,475.00	Facility		$593.00	$2,045.00	$4,475.00
United Facility/Professional Professional Modifier Low / Median / High Price $176.66 / $1,008.52 / $1,736.90	Professional		$176.66	$1,008.52	$1,736.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $845.87 / $989.18 / $1,345.88	Professional		$845.87	$989.18	$1,345.88