Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $499.89 / $2,071.00 / $7,513.00	Facility		$499.89	$2,071.00	$7,513.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,893.00 / $3,903.54 / $9,655.00	Facility	50	$1,893.00	$3,903.54	$9,655.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.45 / $417.00 / $785.64	Professional		$96.45	$417.00	$785.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.36 / $90.36 / $90.36	Professional		$90.36	$90.36	$90.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,328.66 / $2,781.33 / $5,646.61	Facility		$1,328.66	$2,781.33	$5,646.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $462.61 / $879.46	Professional		$90.00	$462.61	$879.46
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $748.00 / $1,775.78 / $5,069.04	Facility		$748.00	$1,775.78	$5,069.04
Christus Facility/Professional Facility Modifier Low / Median / High Price $86.50 / $2,111.57 / $2,111.57	Facility		$86.50	$2,111.57	$2,111.57
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 $110.57 / $255.74 / $857.99	Professional		$110.57	$255.74	$857.99
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,042.07	Facility		$55.00	$55.00	$1,042.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,115.98 / $4,093.84 / $4,811.03	Professional		$2,115.98	$4,093.84	$4,811.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $97.07 / $446.73 / $970.91	Facility		$97.07	$446.73	$970.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.63 / $176.89 / $995.04	Professional		$123.63	$176.89	$995.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $140.69 / $140.69 / $140.69	Professional		$140.69	$140.69	$140.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.07 / $469.07 / $1,115.64	Facility		$97.07	$469.07	$1,115.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.87 / $309.14 / $943.01	Professional		$112.87	$309.14	$943.01
United Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $1,529.00 / $3,400.00	Facility		$369.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $425.12 / $578.52 / $953.57	Professional		$425.12	$578.52	$953.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $471.80 / $525.57 / $750.80	Professional		$471.80	$525.57	$750.80