Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $2,290.87 / $6,918.31	Facility		$537.03	$2,290.87	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $2,754.23 / $3,162.28	Facility	50	$1,380.38	$2,754.23	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $95.50 / $251.19	Professional		$52.48	$95.50	$251.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $83.18 / $389.05 / $794.33	Professional	50	$83.18	$389.05	$794.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	50	$194.98	$194.98	$194.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,318.26 / $2,630.27	Facility		$724.44	$1,318.26	$2,630.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $141.25	Professional		$50.12	$85.11	$141.25
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $870.96 / $1,348.96	Facility		$53.70	$870.96	$1,348.96
Christus Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $724.44 / $724.44	Facility		$47.86	$724.44	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $120.23 / $234.42	Professional		$64.57	$120.23	$234.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $19,498.45 / $19,498.45	Facility		$2,691.53	$19,498.45	$19,498.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Professional		$1,096.48	$1,096.48	$1,096.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $131.83 / $2,089.30	Facility		$54.95	$131.83	$2,089.30
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $1,380.38 / $3,162.28	Facility	50	$1,380.38	$1,380.38	$3,162.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $95.50 / $177.83	Professional		$52.48	$95.50	$177.83
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $389.05 / $794.33	Professional	50	$95.50	$389.05	$794.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $83.18	Professional		$32.36	$33.11	$83.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $177.83 / $354.81	Professional		$173.78	$177.83	$354.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $117.49 / $239.88	Facility		$56.23	$117.49	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $117.49 / $234.42	Professional		$63.10	$117.49	$234.42
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,778.28 / $4,168.69	Facility		$436.52	$1,778.28	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $181.97	Professional		$57.54	$97.72	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $97.72 / $97.72	Professional		$91.20	$97.72	$97.72