Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $647.00 / $2,577.00 / $8,328.00	Facility		$647.00	$2,577.00	$8,328.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.37 / $363.73 / $597.72	Professional		$307.37	$363.73	$597.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.39 / $403.87 / $420.02	Professional		$187.39	$403.87	$420.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $22,313.43 / $43,678.11 / $88,229.78	Facility		$22,313.43	$43,678.11	$88,229.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $290.19 / $360.36 / $561.95	Professional		$290.19	$360.36	$561.95
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $294.36 / $12,675.22 / $49,545.75	Facility		$294.36	$12,675.22	$49,545.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $165.39 / $364.22 / $553.76	Professional		$165.39	$364.22	$553.76
Christus Facility/Professional Facility Modifier Low / Median / High Price $310.94 / $26,564.39 / $26,564.39	Facility		$310.94	$26,564.39	$26,564.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $387.23 / $387.23 / $387.23	Facility		$387.23	$387.23	$387.23
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $38.33 / $38.33 / $38.33	Facility	AS	$38.33	$38.33	$38.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $359.63 / $500.92 / $800.09	Professional		$359.63	$500.92	$800.09
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,897.74 / $52,385.00 / $149,069.65	Facility		$1,897.74	$52,385.00	$149,069.65
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $76.34 / $14,129.69 / $14,129.69	Facility	AS	$76.34	$14,129.69	$14,129.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,700.13 / $13,506.61 / $13,506.61	Professional		$3,700.13	$13,506.61	$13,506.61
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $331.11 / $521.03 / $794.60	Facility		$331.11	$521.03	$794.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $390.05 / $498.78 / $618.49	Professional		$390.05	$498.78	$618.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $339.24 / $371.55 / $723.67	Professional		$339.24	$371.55	$723.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $331.11 / $523.03 / $813.34	Facility		$331.11	$523.03	$813.34
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $137.60 / $137.60 / $137.60	Facility	80	$137.60	$137.60	$137.60
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $38.33 / $38.33 / $116.96	Facility	AS	$38.33	$38.33	$116.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $366.61 / $519.76 / $772.81	Professional		$366.61	$519.76	$772.81
United Facility/Professional Facility Modifier Low / Median / High Price $6,152.00 / $12,850.00 / $48,636.00	Facility		$6,152.00	$12,850.00	$48,636.00
United Facility/Professional Professional Modifier Low / Median / High Price $290.54 / $393.55 / $675.08	Professional		$290.54	$393.55	$675.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $283.80 / $323.08 / $447.00	Professional		$283.80	$323.08	$447.00