Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.18 / $1,942.00 / $7,000.00	Facility		$194.18	$1,942.00	$7,000.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,198.00 / $2,109.71 / $5,003.97	Facility	50	$1,198.00	$2,109.71	$5,003.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.58 / $169.04 / $292.44	Professional		$97.58	$169.04	$292.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.06 / $288.42 / $937.63	Professional	50	$147.06	$288.42	$937.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $115.73 / $227.70	Professional		$47.55	$115.73	$227.70
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $153.68 / $188.21 / $285.00	Professional	50	$153.68	$188.21	$285.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $714.60 / $1,274.92 / $2,736.61	Facility		$714.60	$1,274.92	$2,736.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.12 / $152.59 / $242.82	Professional		$93.12	$152.59	$242.82
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $51.69 / $382.35 / $442.10	Facility		$51.69	$382.35	$442.10
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $164.62 / $305.50	Professional		$64.84	$164.62	$305.50
Christus Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $987.09 / $987.09	Facility		$92.60	$987.09	$987.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.63 / $178.63 / $178.63	Facility		$178.63	$178.63	$178.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.24 / $207.39 / $344.64	Professional		$116.24	$207.39	$344.64
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $524.02 / $30,000.00	Facility		$55.00	$524.02	$30,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,012.00 / $3,500.00 / $3,500.00	Professional		$1,012.00	$3,500.00	$3,500.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $102.70 / $184.56 / $313.69	Facility		$102.70	$184.56	$313.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $132.87 / $205.44 / $335.38	Professional		$132.87	$205.44	$335.38
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $293.06 / $308.16 / $498.50	Professional	50	$293.06	$308.16	$498.50
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,097.29 / $2,499.00 / $6,086.32	Facility		$1,097.29	$2,499.00	$6,086.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.45 / $186.34 / $268.51	Professional		$102.45	$186.34	$268.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.72 / $186.18 / $317.61	Facility		$102.72	$186.18	$317.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $213.88 / $360.53	Professional		$116.28	$213.88	$360.53
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 $154.18 / $208.25 / $358.19	Professional		$154.18	$208.25	$358.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $159.02 / $179.25 / $252.64	Professional		$159.02	$179.25	$252.64