Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $575.00 / $2,485.00 / $6,940.00	Facility		$575.00	$2,485.00	$6,940.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $124.82 / $199.59 / $480.39	Facility	52	$124.82	$199.59	$480.39
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $49.93 / $79.84 / $192.16	Facility	53	$49.93	$79.84	$192.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $249.64 / $563.69 / $922.06	Professional		$249.64	$563.69	$922.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.59 / $300.64 / $323.86	Professional		$228.59	$300.64	$323.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $858.86 / $1,556.54 / $3,323.97	Facility		$858.86	$1,556.54	$3,323.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.54 / $475.35 / $853.70	Professional		$229.54	$475.35	$853.70
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $241.93 / $346.85 / $507.48	Professional		$241.93	$346.85	$507.48
Christus Facility/Professional Facility Modifier Low / Median / High Price $223.30 / $867.79 / $867.79	Facility		$223.30	$867.79	$867.79
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 $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.79 / $577.85 / $1,109.59	Professional		$295.79	$577.85	$1,109.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,452.35 / $11,500.00 / $16,394.00	Facility		$1,452.35	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $926.46 / $1,001.00 / $1,001.00	Facility	52	$926.46	$1,001.00	$1,001.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $231.61 / $250.25 / $250.25	Facility	53	$231.61	$250.25	$250.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,437.02 / $4,654.56 / $5,434.43	Professional		$2,437.02	$4,654.56	$5,434.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $261.99 / $633.32 / $1,050.26	Facility		$261.99	$633.32	$1,050.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $321.69 / $504.91 / $1,118.98	Professional		$321.69	$504.91	$1,118.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $341.14 / $1,453.03 / $3,419.00	Facility		$341.14	$1,453.03	$3,419.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $246.32 / $628.02 / $1,270.07	Professional		$246.32	$628.02	$1,270.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $262.35 / $646.39 / $1,119.35	Facility		$262.35	$646.39	$1,119.35
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $306.58 / $643.10 / $1,403.27	Professional		$306.58	$643.10	$1,403.27
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 $550.03 / $758.64 / $1,209.47	Professional		$550.03	$758.64	$1,209.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $535.02 / $625.84 / $849.84	Professional		$535.02	$625.84	$849.84