Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $2,089.30 / $7,413.10	Facility		$524.81	$2,089.30	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $776.25 / $2,089.30 / $5,248.07	Facility	50	$776.25	$2,089.30	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $186.21 / $467.74	Professional		$100.00	$186.21	$467.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $389.05 / $1,122.02	Professional	50	$154.88	$389.05	$1,122.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $169.82 / $229.09	Professional		$85.11	$169.82	$229.09
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $257.04 / $316.23	Professional	50	$144.54	$257.04	$316.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,288.25 / $2,691.53	Facility		$741.31	$1,288.25	$2,691.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $239.88	Professional		$85.11	$154.88	$239.88
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,230.27 / $2,344.23	Facility		$891.25	$1,230.27	$2,344.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $144.54 / $245.47	Professional		$66.07	$144.54	$245.47
Christus Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $1,000.00 / $1,000.00	Facility		$93.33	$1,000.00	$1,000.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $354.81	Professional		$117.49	$208.93	$354.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $30,199.52 / $30,199.52	Facility		$2,691.53	$30,199.52	$30,199.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Professional		$3,467.37	$3,467.37	$3,467.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $245.47 / $3,467.37	Facility		$102.33	$245.47	$3,467.37
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $724.44 / $2,089.30 / $7,413.10	Facility	50	$724.44	$2,089.30	$7,413.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $186.21 / $371.54	Professional		$102.33	$186.21	$371.54
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $323.59 / $1,096.48	Professional	50	$154.88	$323.59	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $32.36 / $154.88	Professional		$14.79	$32.36	$154.88
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 $223.87 / $223.87 / $363.08	Professional		$223.87	$223.87	$363.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $199.53 / $363.08	Facility		$102.33	$199.53	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $204.17 / $354.81	Professional		$114.82	$204.17	$354.81
United Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $1,778.28 / $4,168.69	Facility		$436.52	$1,778.28	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $309.03	Professional		$93.33	$162.18	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $208.93 / $208.93	Professional		$194.98	$208.93	$208.93