Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.00 / $1,140.00 / $5,055.00	Facility		$127.00	$1,140.00	$5,055.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $726.00 / $1,315.73 / $2,272.38	Facility	50	$726.00	$1,315.73	$2,272.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.33 / $71.87 / $129.35	Professional		$39.33	$71.87	$129.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.54 / $125.24 / $502.50	Professional	50	$48.54	$125.24	$502.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.58 / $38.52 / $87.85	Professional		$34.58	$38.52	$87.85
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.01 / $102.13 / $131.78	Professional	50	$41.01	$102.13	$131.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.68 / $70.12 / $269.37	Facility		$44.68	$70.12	$269.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $62.24 / $95.42	Professional		$37.90	$62.24	$95.42
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $72.45 / $763.00 / $3,329.06	Facility		$72.45	$763.00	$3,329.06
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $25.49 / $58.92 / $115.38	Professional		$25.49	$58.92	$115.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $37.78 / $625.33 / $625.33	Facility		$37.78	$625.33	$625.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.36 / $70.36 / $70.36	Facility		$70.36	$70.36	$70.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.13 / $88.69 / $163.13	Professional		$48.13	$88.69	$163.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $207.96 / $15,000.00	Facility		$55.00	$207.96	$15,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $722.00 / $1,340.00 / $1,340.00	Professional		$722.00	$1,340.00	$1,340.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.61 / $86.36 / $155.50	Facility		$41.61	$86.36	$155.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.14 / $77.89 / $133.57	Professional		$51.14	$77.89	$133.57
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $31.07 / $116.84 / $252.12	Professional	50	$31.07	$116.84	$252.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.79 / $79.31 / $153.47	Professional		$41.79	$79.31	$153.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.87 / $87.26 / $152.57	Facility		$41.87	$87.26	$152.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.45 / $89.98 / $162.97	Professional		$48.45	$89.98	$162.97
United Facility/Professional Facility Modifier Low / Median / High Price $374.00 / $1,529.00 / $3,400.00	Facility		$374.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.94 / $89.41 / $143.43	Professional		$62.94	$89.41	$143.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.29 / $69.17 / $97.35	Professional		$61.29	$69.17	$97.35