Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,276.00 / $5,933.40 / $15,088.35	Facility		$1,276.00	$5,933.40	$15,088.35
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,799.50 / $3,799.50 / $3,799.50	Facility	22	$3,799.50	$3,799.50	$3,799.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,852.77 / $8,024.66 / $21,743.96	Facility	50	$2,852.77	$8,024.66	$21,743.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.17 / $459.50 / $1,555.47	Professional		$382.17	$459.50	$1,555.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $212.38 / $414.85 / $542.46	Professional		$212.38	$414.85	$542.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,039.81 / $7,250.57 / $14,597.80	Facility		$4,039.81	$7,250.57	$14,597.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $348.01 / $430.51 / $673.92	Professional		$348.01	$430.51	$673.92
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $861.72 / $4,782.32 / $11,643.95	Facility		$861.72	$4,782.32	$11,643.95
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $207.60 / $414.95 / $651.30	Professional		$207.60	$414.95	$651.30
Christus Facility/Professional Facility Modifier Low / Median / High Price $412.66 / $5,141.87 / $5,141.87	Facility		$412.66	$5,141.87	$5,141.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,500.00 / $3,720.90 / $4,619.00	Facility		$2,500.00	$3,720.90	$4,619.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $48.91 / $48.91 / $48.91	Facility	AS	$48.91	$48.91	$48.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.53 / $573.37 / $889.84	Professional		$438.53	$573.37	$889.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $11,500.00 / $16,223.75 / $26,542.00	Facility		$11,500.00	$16,223.75	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $96.86 / $1,537.78 / $1,537.78	Facility	AS	$96.86	$1,537.78	$1,537.78
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,959.35 / $3,959.35 / $3,959.35	Professional		$3,959.35	$3,959.35	$3,959.35
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $414.85 / $519.86 / $948.17	Facility		$414.85	$519.86	$948.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $470.38 / $654.26 / $795.37	Professional		$470.38	$654.26	$795.37
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,820.00 / $2,499.00 / $6,204.24	Facility		$1,820.00	$2,499.00	$6,204.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $423.04 / $552.23 / $969.84	Professional		$423.04	$552.23	$969.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $415.74 / $526.64 / $970.53	Facility		$415.74	$526.64	$970.53
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $166.38 / $166.38 / $166.38	Facility	80	$166.38	$166.38	$166.38
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $48.91 / $141.43 / $141.43	Facility	AS	$48.91	$141.43	$141.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $450.00 / $600.78 / $1,089.40	Professional		$450.00	$600.78	$1,089.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,600.00 / $7,019.00 / $16,000.00	Facility		$2,600.00	$7,019.00	$16,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $339.29 / $468.26 / $766.90	Professional		$339.29	$468.26	$766.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $364.96 / $424.50 / $573.41	Professional		$364.96	$424.50	$573.41