Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $3,715.35 / $12,882.50	Facility		$977.24	$3,715.35	$12,882.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,754.23 / $5,623.41 / $14,454.40	Facility	50	$2,754.23	$5,623.41	$14,454.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $426.58 / $1,096.48	Professional		$331.13	$426.58	$1,096.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $354.81 / $436.52	Professional		$309.03	$354.81	$436.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,897.79 / $10,000.00	Facility		$2,818.38	$4,897.79	$10,000.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $338.84 / $537.03	Professional		$288.40	$338.84	$537.03
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $1,318.26 / $3,801.89	Facility		$501.19	$1,318.26	$3,801.89
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $691.83 / $758.58	Professional		$346.74	$691.83	$758.58
Christus Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $3,019.95 / $3,019.95	Facility		$309.03	$3,019.95	$3,019.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,398.83	Facility		$2,398.83	$2,398.83	$2,398.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $741.31	Professional		$354.81	$478.63	$741.31
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,332.54 / $33,884.42 / $33,884.42	Facility		$9,332.54	$33,884.42	$33,884.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,011.87 / $5,011.87 / $5,011.87	Professional		$5,011.87	$5,011.87	$5,011.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $954.99 / $6,606.93	Facility		$346.74	$954.99	$6,606.93
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $4,677.35 / $5,128.61 / $14,454.40	Facility	50	$4,677.35	$5,128.61	$14,454.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $446.68 / $851.14	Professional		$338.84	$446.68	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $724.44 / $870.96	Professional		$5.01	$724.44	$870.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $478.63 / $831.76	Facility		$331.13	$478.63	$831.76
Providence Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $478.63 / $741.31	Professional		$354.81	$478.63	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $4,073.80 / $8,709.64	Facility		$1,380.38	$4,073.80	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $630.96	Professional		$295.12	$407.38	$630.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $323.59	Professional		$302.00	$323.59	$323.59