Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.25 / $1,152.00 / $4,624.00	Facility		$239.25	$1,152.00	$4,624.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $509.90 / $1,080.88 / $1,764.64	Facility	50	$509.90	$1,080.88	$1,764.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $8.81 / $15.81 / $26.52	Facility	53	$8.81	$15.81	$26.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $96.65 / $174.64	Professional		$46.61	$96.65	$174.64
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.27 / $144.97 / $329.02	Professional	50	$72.27	$144.97	$329.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.49 / $94.87 / $123.99	Professional		$45.49	$94.87	$123.99
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $71.86 / $71.86 / $71.86	Professional	50	$71.86	$71.86	$71.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.33 / $657.80 / $3,989.00	Facility		$271.33	$657.80	$3,989.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.38 / $82.51 / $142.28	Professional		$41.38	$82.51	$142.28
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $532.79 / $4,100.00 / $4,100.00	Facility		$532.79	$4,100.00	$4,100.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $56.26 / $102.15 / $218.65	Professional		$56.26	$102.15	$218.65
Christus Facility/Professional Facility Modifier Low / Median / High Price $43.28 / $430.42 / $430.42	Facility		$43.28	$430.42	$430.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.31 / $86.31 / $86.31	Facility		$86.31	$86.31	$86.31
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $17.26 / $17.26 / $17.26	Facility	53	$17.26	$17.26	$17.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.60 / $107.82 / $187.90	Professional		$56.60	$107.82	$187.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $247.48 / $11,500.00 / $12,000.00	Facility		$247.48	$11,500.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $48.61 / $49.50 / $49.50	Facility	53	$48.61	$49.50	$49.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $526.00 / $2,512.54 / $2,512.54	Professional		$526.00	$2,512.54	$2,512.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $109.36 / $220.26	Facility		$50.40	$109.36	$220.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.49 / $124.46 / $196.50	Professional		$63.49	$124.46	$196.50
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $96.43 / $96.43 / $254.79	Professional	50	$96.43	$96.43	$254.79
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $426.32 / $1,089.49 / $5,812.00	Facility		$426.32	$1,089.49	$5,812.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.26 / $109.15 / $213.26	Professional		$49.26	$109.15	$213.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.40 / $109.36 / $218.19	Facility		$50.40	$109.36	$218.19
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $17.26 / $17.26 / $17.26	Facility	53	$17.26	$17.26	$17.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.58 / $108.34 / $204.02	Professional		$57.58	$108.34	$204.02
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $949.00 / $2,290.00	Facility		$161.00	$949.00	$2,290.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.06 / $109.20 / $199.80	Professional		$80.06	$109.20	$199.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $90.55 / $102.01 / $143.94	Professional		$90.55	$102.01	$143.94