Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $2,511.89 / $6,918.31	Facility		$630.96	$2,511.89	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,511.89 / $4,168.69 / $17,782.79	Facility	50	$2,511.89	$4,168.69	$17,782.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $416.87 / $870.96	Professional		$95.50	$416.87	$870.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $707.95 / $4,466.84	Professional	50	$138.04	$707.95	$4,466.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $181.97	Professional		$74.13	$93.33	$181.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $128.82 / $213.80 / $331.13	Professional	50	$128.82	$213.80	$331.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $2,818.38 / $5,623.41	Facility		$1,348.96	$2,818.38	$5,623.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $416.87 / $691.83	Professional		$79.43	$416.87	$691.83
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $2,290.87 / $4,677.35	Facility		$1,047.13	$2,290.87	$4,677.35
Christus Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $2,089.30 / $2,089.30	Facility		$87.10	$2,089.30	$2,089.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility		$1,380.38	$1,380.38	$1,380.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $275.42 / $912.01	Professional		$109.65	$275.42	$912.01
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $5,495.41	Facility		$54.95	$56.23	$5,495.41
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,786.30 / $4,786.30	Professional		$4,073.80	$4,786.30	$4,786.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $741.31 / $4,073.80	Facility		$104.71	$741.31	$4,073.80
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,511.89 / $4,570.88 / $17,782.79	Facility	50	$2,511.89	$4,570.88	$17,782.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $512.86 / $1,023.29	Professional		$97.72	$512.86	$1,023.29
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $446.68 / $3,467.37	Professional	50	$138.04	$446.68	$3,467.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $141.25 / $1,737.80	Professional		$6.03	$141.25	$1,737.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $398.11 / $1,000.00	Facility		$95.50	$398.11	$1,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $269.15 / $933.25	Professional		$109.65	$269.15	$933.25
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,819.70 / $4,168.69	Facility		$436.52	$1,819.70	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $354.81 / $776.25	Professional		$93.33	$354.81	$776.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $562.34 / $562.34	Professional		$537.03	$562.34	$562.34