Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $748.00 / $2,999.00 / $9,004.65	Facility		$748.00	$2,999.00	$9,004.65
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,332.62 / $3,069.75 / $3,838.45	Facility	50	$2,332.62	$3,069.75	$3,838.45
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $145.09 / $157.85 / $227.82	Facility	52	$145.09	$157.85	$227.82
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $58.03 / $63.14 / $91.13	Facility	53	$58.03	$63.14	$91.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.17 / $322.23 / $546.35	Professional		$290.17	$322.23	$546.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,167.91 / $4,648.55 / $8,451.91	Facility		$2,167.91	$4,648.55	$8,451.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.63 / $343.63 / $478.75	Professional		$269.63	$343.63	$478.75
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $623.00 / $3,062.32 / $8,100.00	Facility		$623.00	$3,062.32	$8,100.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $595.75 / $653.83 / $653.83	Professional		$595.75	$653.83	$653.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $262.72 / $2,869.00 / $2,869.00	Facility		$262.72	$2,869.00	$2,869.00
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 $311.88 / $405.38 / $629.22	Professional		$311.88	$405.38	$629.22
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,388.90 / $26,542.00 / $26,542.00	Facility		$9,388.90	$26,542.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $551.76 / $7,119.48 / $7,119.48	Facility	52	$551.76	$7,119.48	$7,119.48
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $137.94 / $1,779.87 / $1,779.87	Facility	53	$137.94	$1,779.87	$1,779.87
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,853.12 / $2,853.12 / $2,853.12	Professional		$2,853.12	$2,853.12	$2,853.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $295.52 / $411.60 / $746.33	Facility		$295.52	$411.60	$746.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $339.09 / $444.92 / $540.89	Professional		$339.09	$444.92	$540.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $466.10 / $466.10 / $466.10	Professional		$466.10	$466.10	$466.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $295.52 / $414.94 / $823.62	Facility		$295.52	$414.94	$823.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $312.52 / $412.00 / $637.36	Professional		$312.52	$412.00	$637.36
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 $251.47 / $345.77 / $534.69	Professional		$251.47	$345.77	$534.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $248.19 / $284.77 / $392.30	Professional		$248.19	$284.77	$392.30