Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $2,089.30 / $5,248.07	Facility		$588.84	$2,089.30	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $323.59 / $1,737.80	Professional		$141.25	$323.59	$1,737.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $165.96 / $933.25	Professional		$89.13	$165.96	$933.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $2,344.23 / $4,677.35	Facility		$1,230.27	$2,344.23	$4,677.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $741.31 / $1,288.25	Professional		$131.83	$741.31	$1,288.25
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $977.24 / $1,584.89	Facility		$223.87	$977.24	$1,584.89
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $208.93 / $1,071.52	Professional		$100.00	$208.93	$1,071.52
Christus Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $1,445.44 / $1,445.44	Facility		$134.90	$1,445.44	$1,445.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $1,122.02 / $1,445.44	Facility		$257.04	$1,122.02	$1,445.44
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	22	$309.03	$309.03	$309.03
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	52	$204.17	$204.17	$204.17
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.29 / $51.29 / $51.29	Facility	53	$51.29	$51.29	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $316.23 / $1,778.28	Professional		$165.96	$316.23	$1,778.28
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 Facility Modifier 53 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	53	$977.24	$977.24	$977.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,413.10 / $8,709.64 / $8,709.64	Professional		$7,413.10	$8,709.64	$8,709.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $575.44 / $2,630.27	Facility		$154.88	$575.44	$2,630.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $354.81 / $1,862.09	Professional		$147.91	$354.81	$1,862.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $851.14	Professional		$32.36	$33.11	$851.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $1,288.25 / $3,981.07	Professional		$229.09	$1,288.25	$3,981.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $309.03 / $1,778.28	Facility		$154.88	$309.03	$1,778.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $346.74 / $1,949.84	Professional		$162.18	$346.74	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,511.89 / $4,786.30	Facility		$676.08	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $251.19 / $1,412.54	Professional		$141.25	$251.19	$1,412.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $1,122.02 / $1,288.25	Professional		$117.49	$1,122.02	$1,288.25