Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.77 / $1,922.00 / $6,762.00	Facility		$75.77	$1,922.00	$6,762.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $299.74 / $1,297.86 / $1,789.20	Facility	50	$299.74	$1,297.86	$1,789.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $74.31 / $123.92	Professional		$47.87	$74.31	$123.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.06 / $148.46 / $282.33	Professional	50	$53.06	$148.46	$282.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.47 / $70.98 / $88.40	Professional		$47.47	$70.98	$88.40
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $74.53 / $84.17 / $107.23	Professional	50	$74.53	$84.17	$107.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.20 / $60.42 / $260.98	Facility		$33.20	$60.42	$260.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.97 / $66.88 / $100.96	Professional		$46.97	$66.88	$100.96
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $57.44 / $325.24 / $650.95	Facility		$57.44	$325.24	$650.95
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $52.52 / $121.85	Professional		$28.87	$52.52	$121.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $44.89 / $365.64 / $365.64	Facility		$44.89	$365.64	$365.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.34 / $90.34 / $90.34	Facility		$90.34	$90.34	$90.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.66 / $95.83 / $175.18	Professional		$59.66	$95.83	$175.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $252.70 / $15,000.00	Facility		$55.00	$252.70	$15,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,157.00 / $1,157.00 / $1,157.00	Professional		$1,157.00	$1,157.00	$1,157.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.00 / $92.54 / $157.46	Facility		$54.00	$92.54	$157.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $66.86 / $95.46 / $132.16	Professional		$66.86	$95.46	$132.16
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $180.18 / $180.18 / $180.18	Professional	50	$180.18	$180.18	$180.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.46 / $84.91 / $167.56	Professional		$51.46	$84.91	$167.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.00 / $92.84 / $159.99	Facility		$54.00	$92.84	$159.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.06 / $100.39 / $175.18	Professional		$62.06	$100.39	$175.18
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $1,058.00 / $2,668.00	Facility		$161.00	$1,058.00	$2,668.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.50 / $92.81 / $154.68	Professional		$63.50	$92.81	$154.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.67 / $70.98 / $98.74	Professional		$62.67	$70.98	$98.74