Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $455.64 / $1,918.50 / $5,906.00	Facility		$455.64	$1,918.50	$5,906.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $96.43 / $155.38 / $320.86	Facility	52	$96.43	$155.38	$320.86
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.57 / $62.16 / $128.34	Facility	53	$38.57	$62.16	$128.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.84 / $400.84 / $662.53	Professional		$192.84	$400.84	$662.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.17 / $108.30 / $188.35	Professional		$94.17	$108.30	$188.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $858.86 / $1,534.00 / $3,263.72	Facility		$858.86	$1,534.00	$3,263.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $331.69 / $567.01	Professional		$177.83	$331.69	$567.01
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $1,170.98 / $4,287.29	Facility		$450.00	$1,170.98	$4,287.29
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $58.86 / $216.60 / $393.39	Professional		$58.86	$216.60	$393.39
Christus Facility/Professional Facility Modifier Low / Median / High Price $174.76 / $641.05 / $641.05	Facility		$174.76	$641.05	$641.05
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 $230.24 / $423.53 / $778.19	Professional		$230.24	$423.53	$778.19
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 $1,794.00 / $3,137.04 / $3,665.78	Professional		$1,794.00	$3,137.04	$3,665.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $202.43 / $445.42 / $757.96	Facility		$202.43	$445.42	$757.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $192.79 / $347.80 / $739.85	Professional		$192.79	$347.80	$739.85
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,453.03 / $2,324.90 / $3,419.00	Facility		$1,453.03	$2,324.90	$3,419.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $192.19 / $423.02 / $862.96	Professional		$192.19	$423.02	$862.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $202.43 / $448.75 / $810.92	Facility		$202.43	$448.75	$810.92
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 $238.64 / $461.73 / $933.83	Professional		$238.64	$461.73	$933.83
United Facility/Professional Facility Modifier Low / Median / High Price $681.00 / $2,250.00 / $4,668.00	Facility		$681.00	$2,250.00	$4,668.00
United Facility/Professional Professional Modifier Low / Median / High Price $347.62 / $477.97 / $751.81	Professional		$347.62	$477.97	$751.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $360.82 / $421.96 / $572.67	Professional		$360.82	$421.96	$572.67