Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,754.23 / $6,918.31	Facility		$707.95	$2,754.23	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $602.56 / $1,096.48	Professional		$257.04	$602.56	$1,096.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $229.09 / $263.03	Professional		$213.80	$229.09	$263.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,621.81 / $3,311.31	Facility		$891.25	$1,621.81	$3,311.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $467.74 / $812.83	Professional		$208.93	$467.74	$812.83
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $1,202.26 / $2,754.23	Facility		$446.68	$1,202.26	$2,754.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $316.23 / $489.78	Professional		$85.11	$316.23	$489.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $912.01 / $912.01	Facility		$223.87	$912.01	$912.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $831.76 / $1,412.54	Facility		$436.52	$831.76	$1,412.54
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	22	$524.81	$524.81	$524.81
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	52	$346.74	$346.74	$346.74
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	53	$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $575.44 / $1,148.15	Professional		$281.84	$575.44	$1,148.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $28,840.32 / $28,840.32	Facility		$3,630.78	$28,840.32	$28,840.32
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility	52	$2,884.03	$2,884.03	$2,884.03
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	53	$724.44	$724.44	$724.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,677.35 / $5,495.41 / $5,495.41	Professional		$4,677.35	$5,495.41	$5,495.41
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $691.83 / $1,584.89	Facility		$263.03	$691.83	$1,584.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $602.56 / $1,174.90	Professional		$257.04	$602.56	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $562.34	Professional		$32.36	$33.11	$562.34
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,951.21 / $4,677.35	Facility		$2,511.89	$2,951.21	$4,677.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $1,096.48 / $1,862.09	Professional		$251.19	$1,096.48	$1,862.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $660.69 / $1,174.90	Facility		$269.15	$660.69	$1,174.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $575.44 / $1,230.27	Professional		$275.42	$575.44	$1,230.27
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,511.89 / $4,786.30	Facility		$724.44	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $537.03 / $954.99	Professional		$251.19	$537.03	$954.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $691.83 / $794.33	Professional		$194.98	$691.83	$794.33