Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,454.23 / $4,358.00 / $14,449.00	Facility		$1,454.23	$4,358.00	$14,449.00
Aetna Facility/Professional Facility Modifier 62 Low / Median / High Price $3,197.00 / $3,197.00 / $3,197.00	Facility	62	$3,197.00	$3,197.00	$3,197.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,835.88 / $12,367.27 / $24,912.98	Facility		$6,835.88	$12,367.27	$24,912.98
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $2,061.44 / $9,775.93 / $22,958.62	Facility		$2,061.44	$9,775.93	$22,958.62
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,392.94 / $8,779.84 / $8,779.84	Facility		$1,392.94	$8,779.84	$8,779.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $1,749.72 / $8,742.00	Facility		$900.00	$1,749.72	$8,742.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,070.46 / $1,070.46 / $1,070.46	Facility	62	$1,070.46	$1,070.46	$1,070.46
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $171.27 / $171.27 / $171.27	Facility	AS	$171.27	$171.27	$171.27
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $3,250.00 / $22,189.40	Facility		$55.00	$3,250.00	$22,189.40
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,112.55 / $13,156.44 / $13,156.44	Facility	62	$2,112.55	$13,156.44	$13,156.44
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $338.01 / $2,105.03 / $2,105.03	Facility	AS	$338.01	$2,105.03	$2,105.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,454.23 / $1,817.65 / $3,414.80	Facility		$1,454.23	$1,817.65	$3,414.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,454.23 / $1,836.86 / $3,502.01	Facility		$1,454.23	$1,836.86	$3,502.01
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,070.46 / $2,299.59 / $2,299.59	Facility	62	$1,070.46	$2,299.59	$2,299.59
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $588.70 / $588.70 / $588.70	Facility	80	$588.70	$588.70	$588.70
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $171.27 / $500.39 / $500.39	Facility	AS	$171.27	$500.39	$500.39
United Facility/Professional Facility Modifier Low / Median / High Price $2,600.00 / $6,998.00 / $16,000.00	Facility		$2,600.00	$6,998.00	$16,000.00