Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $546.05 / $2,396.00 / $7,395.28	Facility		$546.05	$2,396.00	$7,395.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,269.00 / $3,084.91 / $6,499.02	Facility	50	$1,269.00	$3,084.91	$6,499.02
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $74.79 / $202.11 / $255.25	Facility	52	$74.79	$202.11	$255.25
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.91 / $48.42 / $99.84	Facility	53	$29.91	$48.42	$99.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.08 / $272.45 / $590.04	Professional		$149.08	$272.45	$590.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $108.25 / $270.37 / $1,028.00	Professional	50	$108.25	$270.37	$1,028.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.03 / $179.87 / $197.12	Professional		$150.03	$179.87	$197.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,535.57 / $4,678.74 / $9,564.00	Facility		$2,535.57	$4,678.74	$9,564.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.68 / $307.68 / $592.34	Professional		$129.68	$307.68	$592.34
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $212.50 / $3,062.32 / $10,404.58	Facility		$212.50	$3,062.32	$10,404.58
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $153.18 / $168.79 / $337.57	Professional		$153.18	$168.79	$337.57
Christus Facility/Professional Facility Modifier Low / Median / High Price $137.31 / $2,939.08 / $2,939.08	Facility		$137.31	$2,939.08	$2,939.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,376.10 / $2,376.10 / $2,376.10	Facility		$2,376.10	$2,376.10	$2,376.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.46 / $340.66 / $796.73	Professional		$169.46	$340.66	$796.73
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $969.57 / $16,394.00 / $16,394.00	Facility		$969.57	$16,394.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $606.59 / $606.59 / $775.66	Facility	52	$606.59	$606.59	$775.66
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $151.65 / $151.65 / $193.91	Facility	53	$151.65	$151.65	$193.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,561.00 / $4,483.93 / $4,871.00	Professional		$1,561.00	$4,483.93	$4,871.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $162.56 / $412.30 / $1,017.18	Facility		$162.56	$412.30	$1,017.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $195.12 / $313.89 / $652.67	Professional		$195.12	$313.89	$652.67
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,453.03 / $2,889.42 / $6,393.54	Facility		$1,453.03	$2,889.42	$6,393.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,405.30 / $1,405.30 / $1,405.30	Professional		$1,405.30	$1,405.30	$1,405.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.56 / $412.30 / $1,017.18	Facility		$162.56	$412.30	$1,017.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.16 / $378.86 / $833.12	Professional		$173.16	$378.86	$833.12
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 $380.96 / $514.10 / $794.51	Professional		$380.96	$514.10	$794.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $309.47 / $347.55 / $491.45	Professional		$309.47	$347.55	$491.45