Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $4,168.69 / $12,882.50	Facility		$1,122.02	$4,168.69	$12,882.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,818.38 / $5,128.61 / $22,387.21	Facility	50	$2,818.38	$5,128.61	$22,387.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $707.95 / $2,041.74	Professional		$478.63	$707.95	$2,041.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $512.86 / $724.44	Professional		$416.87	$512.86	$724.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,754.23 / $4,897.79 / $9,549.93	Facility		$2,754.23	$4,897.79	$9,549.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $794.33	Professional		$426.58	$501.19	$794.33
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,548.82 / $5,495.41	Facility		$501.19	$1,548.82	$5,495.41
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $707.95 / $912.01	Professional		$501.19	$707.95	$912.01
Christus Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $2,884.03 / $2,884.03	Facility		$489.78	$2,884.03	$2,884.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $2,187.76 / $2,818.38	Facility		$891.25	$2,187.76	$2,818.38
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility	22	$1,071.52	$1,071.52	$1,071.52
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $89.13 / $89.13 / $89.13	Facility	AS	$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $660.69 / $1,096.48	Professional		$436.52	$660.69	$1,096.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,549.93 / $33,884.42 / $33,884.42	Facility		$9,549.93	$33,884.42	$33,884.42
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	AS	$954.99	$954.99	$954.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,570.88 / $4,570.88	Professional		$4,168.69	$4,570.88	$4,570.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $741.31 / $4,365.16	Facility		$512.86	$741.31	$4,365.16
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $3,235.94 / $7,244.36 / $22,387.21	Facility	50	$3,235.94	$7,244.36	$22,387.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $645.65 / $1,318.26	Professional		$489.78	$645.65	$1,318.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $446.68	Professional		$32.36	$33.11	$446.68
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $7,079.46 / $7,244.36	Facility		$3,388.44	$7,079.46	$7,244.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $954.99 / $1,258.93	Professional		$537.03	$954.99	$1,258.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $660.69 / $1,148.15	Facility		$501.19	$660.69	$1,148.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $1,202.26	Professional		$398.11	$660.69	$1,202.26
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $5,011.87 / $10,964.78	Facility		$1,698.24	$5,011.87	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $870.96	Professional		$426.58	$562.34	$870.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $537.03 / $616.60	Professional		$407.38	$537.03	$616.60