Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $474.00 / $1,885.86 / $4,635.00	Facility		$474.00	$1,885.86	$4,635.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,569.49 / $2,447.03 / $4,339.00	Facility	50	$1,569.49	$2,447.03	$4,339.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.11 / $34.69 / $58.88	Facility	53	$19.11	$34.69	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $217.62 / $356.30	Professional		$95.54	$217.62	$356.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $148.93 / $356.70 / $885.64	Professional	50	$148.93	$356.70	$885.64
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $19.48 / $43.94 / $66.89	Professional	53	$19.48	$43.94	$66.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.25 / $226.47 / $275.56	Professional		$100.25	$226.47	$275.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $157.66 / $237.79 / $413.34	Professional	50	$157.66	$237.79	$413.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $690.24 / $1,274.92 / $2,639.16	Facility		$690.24	$1,274.92	$2,639.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.84 / $184.59 / $313.54	Professional		$97.84	$184.59	$313.54
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $439.56 / $947.19 / $4,100.00	Facility		$439.56	$947.19	$4,100.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $70.75 / $154.29 / $360.79	Professional		$70.75	$154.29	$360.79
Christus Facility/Professional Facility Modifier Low / Median / High Price $97.83 / $723.90 / $723.90	Facility		$97.83	$723.90	$723.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.07 / $188.07 / $188.07	Facility		$188.07	$188.07	$188.07
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.61 / $37.61 / $37.61	Facility	53	$37.61	$37.61	$37.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.70 / $227.20 / $414.56	Professional		$121.70	$227.20	$414.56
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $504.08 / $11,500.00 / $32,000.00	Facility		$504.08	$11,500.00	$32,000.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $100.82 / $110.83 / $110.83	Facility	53	$100.82	$110.83	$110.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,052.00 / $4,050.50 / $4,050.50	Professional		$1,052.00	$4,050.50	$4,050.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $109.54 / $239.01 / $491.09	Facility		$109.54	$239.01	$491.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $140.02 / $276.98 / $439.20	Professional		$140.02	$276.98	$439.20
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $250.92 / $395.22 / $805.29	Professional	50	$250.92	$395.22	$805.29
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $217.22 / $1,089.49 / $3,419.00	Facility		$217.22	$1,089.49	$3,419.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.37 / $239.62 / $477.46	Professional		$110.37	$239.62	$477.46
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.54 / $237.79 / $476.88	Facility		$109.54	$237.79	$476.88
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $37.61 / $37.61 / $37.61	Facility	53	$37.61	$37.61	$37.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $122.95 / $232.38 / $450.87	Professional		$122.95	$232.38	$450.87
United Facility/Professional Facility Modifier Low / Median / High Price $374.00 / $1,529.00 / $3,287.00	Facility		$374.00	$1,529.00	$3,287.00
United Facility/Professional Professional Modifier Low / Median / High Price $182.16 / $252.12 / $423.10	Professional		$182.16	$252.12	$423.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $201.53 / $226.47 / $320.44	Professional		$201.53	$226.47	$320.44