Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.53 / $651.41 / $4,635.00	Facility		$62.53	$651.41	$4,635.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $12.33 / $19.38 / $37.68	Facility	52	$12.33	$19.38	$37.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.65 / $61.02 / $102.78	Professional		$24.65	$61.02	$102.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.33 / $28.22 / $42.86	Professional	52	$12.33	$28.22	$42.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.97 / $48.81 / $70.47	Professional		$19.97	$48.81	$70.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $86.13 / $171.18 / $384.88	Facility		$86.13	$171.18	$384.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.90 / $52.44 / $94.65	Professional		$22.90	$52.44	$94.65
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $12.23 / $12.23 / $91.87	Facility		$12.23	$12.23	$91.87
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $14.50 / $34.11 / $114.84	Professional		$14.50	$34.11	$114.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $80.80 / $80.80	Facility		$22.39	$80.80	$80.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.89 / $68.11 / $129.18	Professional		$28.89	$68.11	$129.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $120.22	Facility		$55.00	$55.00	$120.22
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $89.63 / $96.18 / $96.18	Facility	52	$89.63	$96.18	$96.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $263.00 / $549.24 / $570.92	Professional		$263.00	$549.24	$570.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $26.08 / $62.87 / $139.10	Facility		$26.08	$62.87	$139.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $31.12 / $77.79 / $107.71	Professional		$31.12	$77.79	$107.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.20 / $34.20 / $34.20	Professional		$34.20	$34.20	$34.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.08 / $62.83 / $139.10	Facility		$26.08	$62.83	$139.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.94 / $69.53 / $131.15	Professional		$28.94	$69.53	$131.15
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $950.00 / $2,376.00	Facility		$157.00	$950.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $53.44 / $75.56 / $122.99	Professional		$53.44	$75.56	$122.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.07 / $57.42 / $81.15	Professional		$51.07	$57.42	$81.15