Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $1,995.26 / $7,079.46	Facility		$457.09	$1,995.26	$7,079.46
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $933.25 / $2,570.40 / $6,918.31	Facility	50	$933.25	$2,570.40	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $169.82 / $426.58	Professional		$85.11	$169.82	$426.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $346.74 / $1,023.29	Professional	50	$125.89	$346.74	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $144.54 / $229.09	Professional		$61.66	$144.54	$229.09
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $229.09 / $316.23	Professional	50	$125.89	$229.09	$316.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,258.93 / $2,691.53	Facility		$741.31	$1,258.93	$2,691.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $144.54 / $234.42	Professional		$77.62	$144.54	$234.42
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $446.68 / $2,818.38	Facility		$89.13	$446.68	$2,818.38
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $107.15 / $173.78	Professional		$48.98	$107.15	$173.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $977.24 / $977.24	Facility		$79.43	$977.24	$977.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $186.21 / $323.59	Professional		$100.00	$186.21	$323.59
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 $3,090.30 / $3,090.30 / $3,090.30	Professional		$3,090.30	$3,090.30	$3,090.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $223.87 / $3,715.35	Facility		$89.13	$223.87	$3,715.35
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $891.25 / $2,454.71 / $6,918.31	Facility	50	$891.25	$2,454.71	$6,918.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $165.96 / $346.74	Professional		$85.11	$165.96	$346.74
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $125.89 / $346.74 / $1,047.13	Professional	50	$125.89	$346.74	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $32.36 / $141.25	Professional		$12.88	$32.36	$141.25
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 $199.53 / $199.53 / $331.13	Professional		$199.53	$199.53	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $177.83 / $338.84	Facility		$87.10	$177.83	$338.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $181.97 / $323.59	Professional		$97.72	$181.97	$323.59
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 $79.43 / $141.25 / $275.42	Professional		$79.43	$141.25	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $190.55 / $190.55	Professional		$181.97	$190.55	$190.55