Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $637.76 / $2,474.00 / $6,837.00	Facility		$637.76	$2,474.00	$6,837.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $96.68 / $154.65 / $448.78	Facility	52	$96.68	$154.65	$448.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.35 / $334.64 / $869.52	Professional		$193.35	$334.64	$869.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.58 / $195.44 / $261.33	Professional		$170.58	$195.44	$261.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,199.20 / $2,367.25 / $4,718.92	Facility		$1,199.20	$2,367.25	$4,718.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.68 / $496.79 / $804.71	Professional		$180.68	$496.79	$804.71
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $545.00 / $1,598.68 / $3,020.71	Facility		$545.00	$1,598.68	$3,020.71
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $196.82 / $274.35 / $483.88	Professional		$196.82	$274.35	$483.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $174.17 / $1,312.55 / $1,312.55	Facility		$174.17	$1,312.55	$1,312.55
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 $269.18 / $269.18 / $269.18	Facility	52	$269.18	$269.18	$269.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.49 / $448.43 / $980.50	Professional		$228.49	$448.43	$980.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,351.50 / $11,500.00 / $16,394.00	Facility		$1,351.50	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $718.14 / $777.78 / $777.78	Facility	52	$718.14	$777.78	$777.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,271.42 / $4,354.72 / $5,096.78	Professional		$2,271.42	$4,354.72	$5,096.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $198.29 / $407.69 / $879.17	Facility		$198.29	$407.69	$879.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $249.35 / $446.95 / $1,056.76	Professional		$249.35	$446.95	$1,056.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $196.82 / $549.70 / $1,244.57	Professional		$196.82	$549.70	$1,244.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $198.29 / $438.18 / $961.22	Facility		$198.29	$438.18	$961.22
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $269.18 / $269.18 / $269.18	Facility	52	$269.18	$269.18	$269.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $235.59 / $492.49 / $1,252.23	Professional		$235.59	$492.49	$1,252.23
United Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $2,272.00 / $4,739.00	Facility		$720.00	$2,272.00	$4,739.00
United Facility/Professional Professional Modifier Low / Median / High Price $292.39 / $640.13 / $1,061.71	Professional		$292.39	$640.13	$1,061.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $501.06 / $586.11 / $796.35	Professional		$501.06	$586.11	$796.35