Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $292.49 / $1,719.00 / $5,872.00	Facility		$292.49	$1,719.00	$5,872.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $38.86 / $62.46 / $149.13	Facility	52	$38.86	$62.46	$149.13
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $15.54 / $24.98 / $59.66	Facility	53	$15.54	$24.98	$59.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $232.41 / $391.01	Professional		$77.72	$232.41	$391.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.86 / $100.80 / $152.88	Professional	52	$38.86	$100.80	$152.88
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $15.54 / $40.32 / $61.16	Professional	53	$15.54	$40.32	$61.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.10 / $255.38 / $281.97	Professional		$204.10	$255.38	$281.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $520.35 / $882.34 / $1,951.32	Facility		$520.35	$882.34	$1,951.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.89 / $184.10 / $309.49	Professional		$70.89	$184.10	$309.49
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $1,048.28 / $4,100.00	Facility		$77.84	$1,048.28	$4,100.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $235.51 / $362.87	Professional		$94.64	$235.51	$362.87
Christus Facility/Professional Facility Modifier Low / Median / High Price $70.09 / $519.69 / $519.69	Facility		$70.09	$519.69	$519.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $453.50 / $453.50 / $453.50	Facility		$453.50	$453.50	$453.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.83 / $226.57 / $388.18	Professional		$91.83	$226.57	$388.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $388.79 / $12,000.00 / $12,000.00	Facility		$388.79	$12,000.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $289.45 / $311.02 / $311.02	Facility	52	$289.45	$311.02	$311.02
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $72.36 / $77.76 / $77.76	Facility	53	$72.36	$77.76	$77.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $846.46 / $1,582.80 / $1,848.00	Professional		$846.46	$1,582.80	$1,848.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $85.37 / $222.21 / $405.57	Facility		$85.37	$222.21	$405.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $100.50 / $277.11 / $383.69	Professional		$100.50	$277.11	$383.69
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $278.30 / $1,089.49 / $3,419.00	Facility		$278.30	$1,089.49	$3,419.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $262.00 / $262.00 / $262.00	Professional		$262.00	$262.00	$262.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.37 / $222.21 / $411.03	Facility		$85.37	$222.21	$411.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.57 / $234.30 / $408.19	Professional		$92.57	$234.30	$408.19
United Facility/Professional Facility Modifier Low / Median / High Price $410.00 / $1,661.00 / $4,090.00	Facility		$410.00	$1,661.00	$4,090.00
United Facility/Professional Professional Modifier Low / Median / High Price $167.54 / $237.80 / $367.51	Professional		$167.54	$237.80	$367.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.93 / $204.10 / $289.04	Professional		$181.93	$204.10	$289.04