Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $828.00 / $3,682.00 / $12,040.00	Facility		$828.00	$3,682.00	$12,040.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.56 / $212.60 / $505.73	Professional		$177.56	$212.60	$505.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.27 / $219.20 / $291.79	Professional		$199.27	$219.20	$291.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,300.00 / $6,164.09 / $14,543.00	Facility		$3,300.00	$6,164.09	$14,543.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.58 / $208.10 / $328.84	Professional		$167.58	$208.10	$328.84
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $187.00 / $1,649.34 / $8,000.00	Facility		$187.00	$1,649.34	$8,000.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $204.31 / $278.98 / $358.69	Professional		$204.31	$278.98	$358.69
Christus Facility/Professional Facility Modifier Low / Median / High Price $50.51 / $50.51 / $182.80	Facility		$50.51	$50.51	$182.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.34 / $3,603.00 / $6,702.00	Facility		$239.34	$3,603.00	$6,702.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $146.80 / $146.80 / $146.80	Facility	62	$146.80	$146.80	$146.80
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $23.49 / $23.49 / $23.49	Facility	AS	$23.49	$23.49	$23.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.18 / $292.75 / $462.00	Professional		$217.18	$292.75	$462.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,752.26 / $5,897.00 / $5,897.00	Facility		$2,752.26	$5,897.00	$5,897.00
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $283.91 / $598.89 / $621.89	Facility	62	$283.91	$598.89	$621.89
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $45.43 / $95.82 / $99.50	Facility	AS	$45.43	$95.82	$99.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,668.75 / $3,668.75 / $3,668.75	Professional		$3,668.75	$3,668.75	$3,668.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $199.27 / $265.60 / $471.40	Facility		$199.27	$265.60	$471.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $240.17 / $302.88 / $380.84	Professional		$240.17	$302.88	$380.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $218.27 / $333.11 / $729.44	Professional		$218.27	$333.11	$729.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $199.27 / $264.60 / $482.52	Facility		$199.27	$264.60	$482.52
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $146.80 / $146.80 / $311.66	Facility	62	$146.80	$146.80	$311.66
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $79.79 / $79.79 / $79.79	Facility	80	$79.79	$79.79	$79.79
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $23.49 / $23.49 / $67.81	Facility	AS	$23.49	$23.49	$67.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $217.21 / $301.37 / $456.84	Professional		$217.21	$301.37	$456.84
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $3,695.00	Facility		$161.00	$950.00	$3,695.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.86 / $221.99 / $361.73	Professional		$166.86	$221.99	$361.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $174.75 / $199.27 / $272.70	Professional		$174.75	$199.27	$272.70