Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $609.29 / $2,496.00 / $5,288.82	Facility		$609.29	$2,496.00	$5,288.82
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $96.43 / $223.23 / $328.38	Facility	52	$96.43	$223.23	$328.38
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.57 / $62.16 / $125.79	Facility	53	$38.57	$62.16	$125.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.95 / $435.00 / $867.11	Professional		$193.95	$435.00	$867.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $96.43 / $199.77 / $299.57	Professional	52	$96.43	$199.77	$299.57
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.57 / $78.64 / $114.46	Professional	53	$38.57	$78.64	$114.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.73 / $215.53 / $315.04	Professional		$182.73	$215.53	$315.04
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $24.25 / $44.62 / $63.76	Professional	52	$24.25	$44.62	$63.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $853.59 / $1,536.46 / $3,313.93	Facility		$853.59	$1,536.46	$3,313.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.06 / $331.02 / $555.50	Professional		$180.06	$331.02	$555.50
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $535.20 / $1,112.40 / $2,926.50	Facility		$535.20	$1,112.40	$2,926.50
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $70.63 / $279.32 / $676.67	Professional		$70.63	$279.32	$676.67
Christus Facility/Professional Facility Modifier Low / Median / High Price $174.76 / $1,092.20 / $1,092.20	Facility		$174.76	$1,092.20	$1,092.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $684.87 / $908.58 / $2,213.00	Facility		$684.87	$908.58	$2,213.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.10 / $437.59 / $787.94	Professional		$231.10	$437.59	$787.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,129.75 / $11,500.00 / $16,394.00	Facility		$1,129.75	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $721.81 / $779.08 / $779.08	Facility	52	$721.81	$779.08	$779.08
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $180.45 / $194.77 / $194.77	Facility	53	$180.45	$194.77	$194.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,623.05 / $3,135.42 / $3,595.05	Professional		$1,623.05	$3,135.42	$3,595.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $203.07 / $447.63 / $867.11	Facility		$203.07	$447.63	$867.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $212.07 / $337.38 / $740.20	Professional		$212.07	$337.38	$740.20
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $182.50 / $231.60 / $240.14	Professional	52	$182.50	$231.60	$240.14
Moda Health Facility/Professional Professional Modifier 53 Low / Median / High Price $60.09 / $67.50 / $159.75	Professional	53	$60.09	$67.50	$159.75
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $170.57 / $1,998.24 / $2,896.00	Facility		$170.57	$1,998.24	$2,896.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $192.19 / $414.88 / $846.74	Professional		$192.19	$414.88	$846.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $203.07 / $447.77 / $825.57	Facility		$203.07	$447.77	$825.57
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $240.73 / $467.70 / $929.25	Professional		$240.73	$467.70	$929.25
United Facility/Professional Facility Modifier Low / Median / High Price $593.00 / $2,045.00 / $4,480.00	Facility		$593.00	$2,045.00	$4,480.00
United Facility/Professional Professional Modifier Low / Median / High Price $356.05 / $481.55 / $762.50	Professional		$356.05	$481.55	$762.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $353.92 / $413.89 / $561.69	Professional		$353.92	$413.89	$561.69