Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,215.00 / $6,060.81 / $13,934.25	Facility		$1,215.00	$6,060.81	$13,934.25
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $4,149.00 / $4,149.00 / $4,149.00	Facility	22	$4,149.00	$4,149.00	$4,149.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $343.13 / $369.50 / $2,025.00	Facility	52	$343.13	$369.50	$2,025.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,060.32 / $7,250.57 / $14,694.48	Facility		$4,060.32	$7,250.57	$14,694.48
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $2,200.00 / $5,478.35 / $14,020.44	Facility		$2,200.00	$5,478.35	$14,020.44
Christus Facility/Professional Facility Modifier Low / Median / High Price $667.32 / $5,629.29 / $5,629.29	Facility		$667.32	$5,629.29	$5,629.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,094.91 / $4,105.82 / $9,352.00	Facility		$3,094.91	$4,105.82	$9,352.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $645.72 / $645.72 / $645.72	Facility	52	$645.72	$645.72	$645.72
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.72 / $80.72 / $80.72	Facility	AS	$80.72	$80.72	$80.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,389.76 / $10,160.00 / $16,223.75	Facility		$5,389.76	$10,160.00	$16,223.75
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,270.22 / $12,302.24 / $12,302.24	Facility	52	$1,270.22	$12,302.24	$12,302.24
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $158.78 / $1,537.78 / $1,537.78	Facility	AS	$158.78	$1,537.78	$1,537.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $697.12 / $902.24 / $1,695.86	Facility		$697.12	$902.24	$1,695.86
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,749.82 / $2,740.00 / $12,361.00	Facility		$1,749.82	$2,740.00	$12,361.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $698.61 / $909.68 / $1,805.27	Facility		$698.61	$909.68	$1,805.27
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $645.72 / $645.72 / $645.72	Facility	52	$645.72	$645.72	$645.72
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $276.23 / $276.23 / $276.23	Facility	80	$276.23	$276.23	$276.23
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $80.72 / $234.80 / $234.80	Facility	AS	$80.72	$234.80	$234.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,605.00 / $7,096.00 / $16,000.00	Facility		$2,605.00	$7,096.00	$16,000.00