Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,276.00 / $5,216.00 / $12,497.47	Facility		$1,276.00	$5,216.00	$12,497.47
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,917.00 / $1,917.00 / $6,745.00	Facility	22	$1,917.00	$1,917.00	$6,745.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,017.00 / $6,197.83 / $13,264.50	Facility	50	$3,017.00	$6,197.83	$13,264.50
Aetna Facility/Professional Facility Modifier 80 Low / Median / High Price $2,717.00 / $2,717.00 / $2,717.00	Facility	80	$2,717.00	$2,717.00	$2,717.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,156.99 / $7,588.92 / $14,694.48	Facility		$4,156.99	$7,588.92	$14,694.48
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $473.22 / $5,237.89 / $12,618.47	Facility		$473.22	$5,237.89	$12,618.47
Christus Facility/Professional Facility Modifier Low / Median / High Price $574.73 / $5,975.00 / $5,975.00	Facility		$574.73	$5,975.00	$5,975.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,105.82 / $4,105.82 / $9,229.00	Facility		$4,105.82	$4,105.82	$9,229.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $11,500.00 / $26,542.00 / $26,542.00	Facility		$11,500.00	$26,542.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $146.93 / $1,537.78 / $1,537.78	Facility	AS	$146.93	$1,537.78	$1,537.78
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $633.49 / $865.09 / $1,713.12	Facility		$633.49	$865.09	$1,713.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $633.49 / $866.63 / $1,713.12	Facility		$633.49	$866.63	$1,713.12
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $248.99 / $248.99 / $248.99	Facility	80	$248.99	$248.99	$248.99
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $211.64 / $211.64 / $211.64	Facility	AS	$211.64	$211.64	$211.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,608.00 / $7,350.00 / $16,000.00	Facility		$2,608.00	$7,350.00	$16,000.00