Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $727.00 / $2,970.00 / $8,977.90	Facility		$727.00	$2,970.00	$8,977.90
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $108.00 / $173.44 / $522.52	Facility	52	$108.00	$173.44	$522.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.00 / $616.70 / $999.43	Professional		$216.00	$616.70	$999.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $191.31 / $210.23 / $323.00	Professional		$191.31	$210.23	$323.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,284.65 / $2,440.84 / $5,279.59	Facility		$1,284.65	$2,440.84	$5,279.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.28 / $579.10 / $938.05	Professional		$203.28	$579.10	$938.05
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $336.86 / $1,267.26 / $8,000.00	Facility		$336.86	$1,267.26	$8,000.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $241.76 / $307.49 / $416.45	Professional		$241.76	$307.49	$416.45
Christus Facility/Professional Facility Modifier Low / Median / High Price $194.60 / $1,316.90 / $1,316.90	Facility		$194.60	$1,316.90	$1,316.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,241.33 / $1,646.79 / $3,559.00	Facility		$1,241.33	$1,646.79	$3,559.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.30 / $508.06 / $1,180.68	Professional		$256.30	$508.06	$1,180.68
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,514.10 / $3,598.00 / $3,598.00	Facility		$1,514.10	$3,598.00	$3,598.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $805.34 / $870.09 / $870.09	Facility	52	$805.34	$870.09	$870.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,647.15 / $5,068.16 / $5,941.05	Professional		$2,647.15	$5,068.16	$5,941.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $218.50 / $616.70 / $1,143.01	Facility		$218.50	$616.70	$1,143.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $279.63 / $437.03 / $1,220.59	Professional		$279.63	$437.03	$1,220.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $238.59 / $725.39 / $1,151.51	Professional		$238.59	$725.39	$1,151.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $218.52 / $637.10 / $1,306.22	Facility		$218.52	$637.10	$1,306.22
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $263.83 / $588.52 / $1,468.43	Professional		$263.83	$588.52	$1,468.43
United Facility/Professional Facility Modifier Low / Median / High Price $597.00 / $2,045.00 / $4,480.00	Facility		$597.00	$2,045.00	$4,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $587.54 / $781.28 / $1,248.51	Professional		$587.54	$781.28	$1,248.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $583.61 / $682.57 / $927.46	Professional		$583.61	$682.57	$927.46