Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $330.43 / $1,856.00 / $5,404.00	Facility		$330.43	$1,856.00	$5,404.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $34.61 / $144.72 / $207.23	Facility	52	$34.61	$144.72	$207.23
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $13.84 / $22.54 / $82.89	Facility	53	$13.84	$22.54	$82.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $157.77 / $426.89	Professional		$68.59	$157.77	$426.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $68.30 / $133.66	Professional		$35.08	$68.30	$133.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $638.98 / $1,191.65 / $2,574.28	Facility		$638.98	$1,191.65	$2,574.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.25 / $224.25 / $367.64	Professional		$65.25	$224.25	$367.64
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $406.00 / $923.65 / $2,463.79	Facility		$406.00	$923.65	$2,463.79
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $71.72 / $100.33 / $177.60	Professional		$71.72	$100.33	$177.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $65.40 / $486.07 / $486.07	Facility		$65.40	$486.07	$486.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $529.61 / $702.60 / $1,652.00	Facility		$529.61	$702.60	$1,652.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.26 / $198.54 / $423.85	Professional		$81.26	$198.54	$423.85
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $411.30 / $11,500.00 / $12,000.00	Facility		$411.30	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $262.79 / $287.27 / $287.27	Facility	52	$262.79	$287.27	$287.27
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $65.70 / $71.81 / $71.81	Facility	53	$65.70	$71.81	$71.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,049.33 / $2,011.44 / $2,370.00	Professional		$1,049.33	$2,011.44	$2,370.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $72.18 / $183.73 / $358.27	Facility		$72.18	$183.73	$358.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $82.33 / $140.61 / $476.05	Professional		$82.33	$140.61	$476.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $738.43 / $1,215.00 / $4,095.84	Facility		$738.43	$1,215.00	$4,095.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.06 / $272.08 / $634.88	Professional		$77.06	$272.08	$634.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.53 / $188.58 / $398.96	Facility		$72.53	$188.58	$398.96
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $84.23 / $217.00 / $543.79	Professional		$84.23	$217.00	$543.79
United Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $1,513.00 / $3,260.00	Facility		$369.00	$1,513.00	$3,260.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.73 / $260.64 / $438.48	Professional		$166.73	$260.64	$438.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $232.17 / $271.47 / $369.10	Professional		$232.17	$271.47	$369.10