Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,076.00 / $4,132.00 / $12,826.00	Facility		$1,076.00	$4,132.00	$12,826.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,189.35 / $6,484.50 / $17,736.00	Facility	50	$4,189.35	$6,484.50	$17,736.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,144.47 / $9,272.02 / $18,065.49	Facility		$5,144.47	$9,272.02	$18,065.49
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $2,198.85 / $7,051.50 / $22,325.87	Facility		$2,198.85	$7,051.50	$22,325.87
Christus Facility/Professional Facility Modifier Low / Median / High Price $870.70 / $7,155.23 / $7,155.23	Facility		$870.70	$7,155.23	$7,155.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,043.79 / $3,603.00 / $6,702.00	Facility		$1,043.79	$3,603.00	$6,702.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $103.83 / $103.83 / $103.83	Facility	AS	$103.83	$103.83	$103.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.00 / $19,913.50 / $30,000.00	Facility		$5,897.00	$19,913.50	$30,000.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $202.65 / $1,887.52 / $1,887.52	Facility	AS	$202.65	$1,887.52	$1,887.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $898.92 / $1,159.78 / $2,154.56	Facility		$898.92	$1,159.78	$2,154.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $898.92 / $1,159.78 / $2,205.37	Facility		$898.92	$1,159.78	$2,205.37
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $372.59 / $372.59 / $372.59	Facility	80	$372.59	$372.59	$372.59
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $103.83 / $103.83 / $316.70	Facility	AS	$103.83	$103.83	$316.70
United Facility/Professional Facility Modifier Low / Median / High Price $2,605.00 / $7,350.00 / $16,000.00	Facility		$2,605.00	$7,350.00	$16,000.00