Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,104.21 / $4,094.44 / $12,483.00	Facility		$1,104.21	$4,094.44	$12,483.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,261.50 / $1,261.50 / $1,261.50	Facility	22	$1,261.50	$1,261.50	$1,261.50
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 $5,069.04 / $6,707.82 / $13,935.48	Facility		$5,069.04	$6,707.82	$13,935.48
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,034.33 / $5,912.71 / $5,912.71	Facility		$1,034.33	$5,912.71	$5,912.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,260.01 / $3,603.00 / $6,702.00	Facility		$1,260.01	$3,603.00	$6,702.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $783.15 / $783.15 / $783.15	Facility	62	$783.15	$783.15	$783.15
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $125.30 / $125.30 / $125.30	Facility	AS	$125.30	$125.30	$125.30
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.00 / $19,913.50 / $25,000.00	Facility		$5,897.00	$19,913.50	$25,000.00
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,522.64 / $11,796.97 / $11,796.97	Facility	62	$1,522.64	$11,796.97	$11,796.97
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $243.62 / $1,887.52 / $1,887.52	Facility	AS	$243.62	$1,887.52	$1,887.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,060.32 / $1,370.80 / $2,442.60	Facility		$1,060.32	$1,370.80	$2,442.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,060.32 / $1,368.70 / $2,500.21	Facility		$1,060.32	$1,368.70	$2,500.21
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $783.15 / $783.15 / $1,648.16	Facility	62	$783.15	$783.15	$1,648.16
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $421.93 / $421.93 / $421.93	Facility	80	$421.93	$421.93	$421.93
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $125.30 / $125.30 / $358.64	Facility	AS	$125.30	$125.30	$358.64
United Facility/Professional Facility Modifier Low / Median / High Price $2,605.00 / $7,333.00 / $16,000.00	Facility		$2,605.00	$7,333.00	$16,000.00