Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,202.26 / $5,128.61	Facility		$436.52	$1,202.26	$5,128.61
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $691.83 / $1,071.52 / $1,778.28	Facility	50	$691.83	$1,071.52	$1,778.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $102.33 / $288.40	Professional		$48.98	$102.33	$288.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $158.49 / $630.96	Professional	50	$72.44	$158.49	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $74.13 / $123.03	Professional		$44.67	$74.13	$123.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $151.36 / $181.97	Professional	50	$72.44	$151.36	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $630.96 / $3,715.35	Facility		$281.84	$630.96	$3,715.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $79.43 / $138.04	Professional		$40.74	$79.43	$138.04
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $1,023.29 / $4,073.80	Facility		$51.29	$1,023.29	$4,073.80
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $102.33 / $186.21	Professional		$48.98	$102.33	$186.21
Christus Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $426.58 / $426.58	Facility		$43.65	$426.58	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $107.15 / $199.53	Professional		$56.23	$107.15	$199.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $19,498.45 / $19,498.45	Facility		$1,995.26	$19,498.45	$19,498.45
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	53	$295.12	$295.12	$295.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Professional		$2,511.89	$2,511.89	$2,511.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $141.25 / $1,995.26	Facility		$50.12	$141.25	$1,995.26
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $512.86 / $1,071.52 / $2,511.89	Facility	50	$512.86	$1,071.52	$2,511.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $100.00 / $213.80	Professional		$48.98	$100.00	$213.80
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $147.91 / $416.87	Professional	50	$69.18	$147.91	$416.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,019.95 / $3,388.44	Facility		$2,344.23	$3,019.95	$3,388.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $269.15 / $436.52	Professional		$158.49	$269.15	$436.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $117.49 / $223.87	Facility		$50.12	$117.49	$223.87
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	53	$17.38	$17.38	$17.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $107.15 / $194.98	Professional		$56.23	$107.15	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,047.13 / $2,691.53	Facility		$158.49	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $85.11 / $165.96	Professional		$45.71	$85.11	$165.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $117.49	Professional		$112.20	$117.49	$117.49