Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.50 / $1,655.00 / $5,906.00	Facility		$120.50	$1,655.00	$5,906.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $29.12 / $48.56 / $65.51	Facility	52	$29.12	$48.56	$65.51
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.65 / $19.42 / $24.46	Facility	53	$11.65	$19.42	$24.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.24 / $97.79 / $214.62	Professional		$58.24	$97.79	$214.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.12 / $48.45 / $67.52	Professional	52	$29.12	$48.45	$67.52
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $11.65 / $19.42 / $28.23	Professional	53	$11.65	$19.42	$28.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.75 / $85.62 / $131.72	Professional		$51.75	$85.62	$131.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.48 / $74.28 / $309.24	Facility		$45.48	$74.28	$309.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.25 / $86.67 / $157.03	Professional		$53.25	$86.67	$157.03
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $82.80 / $193.47 / $740.00	Facility		$82.80	$193.47	$740.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $59.53 / $139.54 / $175.01	Professional		$59.53	$139.54	$175.01
Christus Facility/Professional Facility Modifier Low / Median / High Price $54.26 / $65.78 / $65.78	Facility		$54.26	$65.78	$65.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.28 / $74.28 / $74.28	Facility		$74.28	$74.28	$74.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.28 / $122.24 / $205.70	Professional		$71.28	$122.24	$205.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $303.00	Facility		$55.00	$55.00	$303.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $228.87 / $242.40 / $242.40	Facility	52	$228.87	$242.40	$242.40
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $57.22 / $60.60 / $60.60	Facility	53	$57.22	$60.60	$60.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $452.72 / $719.92 / $845.55	Professional		$452.72	$719.92	$845.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.50 / $122.32 / $201.70	Facility		$66.50	$122.32	$201.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.47 / $126.57 / $173.68	Professional		$79.47	$126.57	$173.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.98 / $111.65 / $119.03	Professional		$64.98	$111.65	$119.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.23 / $123.08 / $206.45	Facility		$67.23	$123.08	$206.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.48 / $127.79 / $208.25	Professional		$72.48	$127.79	$208.25
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 $82.98 / $111.16 / $177.02	Professional		$82.98	$111.16	$177.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.09 / $94.09 / $131.44	Professional		$83.09	$94.09	$131.44