Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $2,396.00 / $7,495.00	Facility		$633.00	$2,396.00	$7,495.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $11,112.00 / $11,112.00 / $12,912.00	Facility	50	$11,112.00	$11,112.00	$12,912.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $98.75 / $157.31 / $572.69	Facility	52	$98.75	$157.31	$572.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.50 / $62.92 / $229.08	Facility	53	$39.50	$62.92	$229.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.50 / $684.27 / $1,184.08	Professional		$197.50	$684.27	$1,184.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.15 / $181.15 / $181.15	Professional		$181.15	$181.15	$181.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,626.93 / $2,834.48 / $6,101.00	Facility		$1,626.93	$2,834.48	$6,101.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.02 / $721.64 / $1,339.07	Professional		$185.02	$721.64	$1,339.07
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $796.32 / $1,775.78 / $4,088.35	Facility		$796.32	$1,775.78	$4,088.35
Christus Facility/Professional Facility Modifier Low / Median / High Price $175.48 / $2,638.80 / $2,638.80	Facility		$175.48	$2,638.80	$2,638.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,377.85 / $1,377.85 / $1,377.85	Facility		$1,377.85	$1,377.85	$1,377.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.36 / $515.03 / $1,392.36	Professional		$230.36	$515.03	$1,392.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,601.53	Facility		$55.00	$55.00	$1,601.53
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $727.83 / $782.54 / $782.54	Facility	52	$727.83	$782.54	$782.54
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $181.96 / $195.63 / $195.63	Facility	53	$181.96	$195.63	$195.63
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,242.87 / $6,260.24 / $7,329.60	Professional		$3,242.87	$6,260.24	$7,329.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $197.50 / $683.81 / $1,484.22	Facility		$197.50	$683.81	$1,484.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $252.72 / $928.31 / $1,519.06	Professional		$252.72	$928.31	$1,519.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $264.60 / $264.60 / $264.60	Professional		$264.60	$264.60	$264.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $197.50 / $765.03 / $1,793.57	Facility		$197.50	$765.03	$1,793.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $231.48 / $615.94 / $1,523.10	Professional		$231.48	$615.94	$1,523.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,314.00 / $7,600.00	Facility		$1,154.00	$3,314.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $714.12 / $981.50 / $1,548.71	Professional		$714.12	$981.50	$1,548.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $720.26 / $804.48 / $1,145.69	Professional		$720.26	$804.48	$1,145.69