Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $624.00 / $2,485.00 / $7,316.00	Facility		$624.00	$2,485.00	$7,316.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.49 / $737.40 / $1,200.83	Professional		$194.49	$737.40	$1,200.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.40 / $322.91 / $371.58	Professional		$173.40	$322.91	$371.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,210.97 / $2,382.82 / $4,734.50	Facility		$1,210.97	$2,382.82	$4,734.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.89 / $597.98 / $1,073.95	Professional		$181.89	$597.98	$1,073.95
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $916.64 / $1,824.37 / $3,432.54	Facility		$916.64	$1,824.37	$3,432.54
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $285.83 / $437.65	Professional		$190.55	$285.83	$437.65
Christus Facility/Professional Facility Modifier Low / Median / High Price $3.67 / $3.67 / $176.00	Facility		$3.67	$3.67	$176.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $935.02 / $1,240.44 / $1,652.00	Facility		$935.02	$1,240.44	$1,652.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $274.70 / $274.70 / $274.70	Facility	52	$274.70	$274.70	$274.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $68.68 / $68.68 / $68.68	Facility	53	$68.68	$68.68	$68.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.30 / $466.43 / $1,636.03	Professional		$232.30	$466.43	$1,636.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,465.89	Facility		$55.00	$55.00	$1,465.89
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $727.83 / $782.61 / $782.61	Facility	52	$727.83	$782.61	$782.61
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $181.96 / $195.65 / $195.65	Facility	53	$181.96	$195.65	$195.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,976.58 / $6,044.48 / $6,714.23	Professional		$2,976.58	$6,044.48	$6,714.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $200.08 / $711.02 / $1,603.55	Facility		$200.08	$711.02	$1,603.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $252.72 / $850.39 / $1,391.54	Professional		$252.72	$850.39	$1,391.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.85 / $1,045.81 / $2,238.69	Professional		$194.85	$1,045.81	$2,238.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $200.08 / $732.63 / $1,672.57	Facility		$200.08	$732.63	$1,672.57
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $274.70 / $274.70 / $274.70	Facility	52	$274.70	$274.70	$274.70
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $68.68 / $68.68 / $68.68	Facility	53	$68.68	$68.68	$68.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $547.40 / $1,887.52	Professional		$240.00	$547.40	$1,887.52
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 $790.43 / $1,067.42 / $1,753.79	Professional		$790.43	$1,067.42	$1,753.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $659.80 / $771.88 / $1,049.27	Professional		$659.80	$771.88	$1,049.27