Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.50 / $3,730.00 / $9,369.99	Facility		$801.50	$3,730.00	$9,369.99
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $105.75 / $180.92 / $823.05	Facility	52	$105.75	$180.92	$823.05
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $42.30 / $72.37 / $329.22	Facility	53	$42.30	$72.37	$329.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.49 / $397.02 / $1,640.28	Professional		$211.49	$397.02	$1,640.28
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $42.30 / $79.40 / $324.62	Professional	53	$42.30	$79.40	$324.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.57 / $271.37 / $1,404.84	Professional		$199.57	$271.37	$1,404.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,128.00 / $3,922.02 / $7,669.17	Facility		$2,128.00	$3,922.02	$7,669.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.58 / $628.54 / $1,725.30	Professional		$187.58	$628.54	$1,725.30
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $3,503.15 / $8,380.56	Facility		$675.00	$3,503.15	$8,380.56
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $219.30 / $290.69 / $460.47	Professional		$219.30	$290.69	$460.47
Christus Facility/Professional Facility Modifier Low / Median / High Price $200.81 / $2,598.34 / $2,598.34	Facility		$200.81	$2,598.34	$2,598.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,403.30 / $2,403.30 / $4,558.00	Facility		$2,403.30	$2,403.30	$4,558.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.01 / $503.11 / $1,892.03	Professional		$255.01	$503.11	$1,892.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,294.04 / $26,542.00 / $26,542.00	Facility		$2,294.04	$26,542.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $840.46 / $896.65 / $896.65	Facility	52	$840.46	$896.65	$896.65
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $210.11 / $224.16 / $224.16	Facility	53	$210.11	$224.16	$224.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,713.31 / $8,969.32 / $10,538.93	Professional		$4,713.31	$8,969.32	$10,538.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $241.40 / $488.06 / $1,774.96	Facility		$241.40	$488.06	$1,774.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $291.82 / $570.71 / $2,172.91	Professional		$291.82	$570.71	$2,172.91
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,659.00 / $2,649.29 / $6,094.00	Facility		$1,659.00	$2,649.29	$6,094.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $241.26 / $434.90 / $1,510.90	Professional		$241.26	$434.90	$1,510.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $241.23 / $488.06 / $1,704.28	Facility		$241.23	$488.06	$1,704.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $260.14 / $540.35 / $2,017.39	Professional		$260.14	$540.35	$2,017.39
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 $328.51 / $1,069.47 / $2,226.89	Professional		$328.51	$1,069.47	$2,226.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,030.28 / $1,147.94 / $1,637.79	Professional		$1,030.28	$1,147.94	$1,637.79