Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.68 / $1,871.00 / $6,000.00	Facility		$198.68	$1,871.00	$6,000.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $14.43 / $25.80 / $44.41	Facility	53	$14.43	$25.80	$44.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $160.36 / $281.82	Professional		$76.23	$160.36	$281.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.18 / $95.20 / $152.46	Professional		$78.18	$95.20	$152.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $467.00 / $2,673.00 / $4,277.00	Facility		$467.00	$2,673.00	$4,277.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.04 / $156.00 / $287.58	Professional		$77.04	$156.00	$287.58
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $178.68 / $178.68 / $178.68	Professional		$178.68	$178.68	$178.68
Christus Facility/Professional Facility Modifier Low / Median / High Price $70.81 / $138.00 / $138.00	Facility		$70.81	$138.00	$138.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $140.54	Facility		$140.54	$140.54	$140.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $28.11 / $28.11	Facility	53	$28.11	$28.11	$28.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.16 / $176.64 / $338.51	Professional		$93.16	$176.64	$338.51
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $404.80 / $580.01	Facility		$55.00	$404.80	$580.01
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $74.79 / $80.95 / $80.95	Facility	53	$74.79	$80.95	$80.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,088.00 / $1,537.05 / $1,604.71	Professional		$1,088.00	$1,537.05	$1,604.71
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $80.20 / $174.55 / $351.64	Facility		$80.20	$174.55	$351.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $103.87 / $231.28 / $443.92	Professional		$103.87	$231.28	$443.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.42 / $210.55 / $376.50	Professional		$85.42	$210.55	$376.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.72 / $176.41 / $351.90	Facility		$80.72	$176.41	$351.90
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $28.11 / $28.11	Facility	53	$28.11	$28.11	$28.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $96.79 / $197.11 / $401.10	Professional		$96.79	$197.11	$401.10
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $952.00 / $2,376.00	Facility		$161.00	$952.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.41 / $219.69 / $369.81	Professional		$163.41	$219.69	$369.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.84 / $170.80 / $241.22	Professional		$151.84	$170.80	$241.22