Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $682.25 / $2,360.92 / $6,403.61	Facility		$682.25	$2,360.92	$6,403.61
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $929.50 / $2,295.00 / $4,846.60	Facility	50	$929.50	$2,295.00	$4,846.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $505.13 / $599.32 / $1,074.75	Professional		$505.13	$599.32	$1,074.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $580.95 / $639.04 / $825.28	Professional		$580.95	$639.04	$825.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,530.22 / $2,699.38 / $5,673.85	Facility		$1,530.22	$2,699.38	$5,673.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $487.21 / $606.41 / $943.49	Professional		$487.21	$606.41	$943.49
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $588.72 / $1,878.02 / $4,500.00	Facility		$588.72	$1,878.02	$4,500.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $585.48 / $836.35 / $1,074.78	Professional		$585.48	$836.35	$1,074.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $558.47 / $1,490.38 / $1,490.38	Facility		$558.47	$1,490.38	$1,490.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.89 / $691.89 / $691.89	Facility		$691.89	$691.89	$691.89
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $68.64 / $68.64 / $68.64	Facility	AS	$68.64	$68.64	$68.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $607.42 / $805.99 / $1,212.08	Professional		$607.42	$805.99	$1,212.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,281.32 / $11,500.00 / $16,394.00	Facility		$2,281.32	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $139.63 / $497.27 / $497.27	Facility	AS	$139.63	$497.27	$497.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,838.31 / $5,838.31 / $5,838.31	Professional		$5,838.31	$5,838.31	$5,838.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $553.90 / $677.74 / $1,204.50	Facility		$553.90	$677.74	$1,204.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $664.70 / $859.14 / $1,119.05	Professional		$664.70	$859.14	$1,119.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $595.66 / $1,453.03 / $5,733.00	Facility		$595.66	$1,453.03	$5,733.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $592.98 / $1,012.79 / $2,225.04	Professional		$592.98	$1,012.79	$2,225.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $553.91 / $686.10 / $1,223.54	Facility		$553.91	$686.10	$1,223.54
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $68.64 / $68.64 / $195.05	Facility	AS	$68.64	$68.64	$195.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $613.08 / $820.43 / $1,245.51	Professional		$613.08	$820.43	$1,245.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,154.00 / $3,326.00 / $7,600.00	Facility		$1,154.00	$3,326.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $463.94 / $634.54 / $977.36	Professional		$463.94	$634.54	$977.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $513.48 / $580.95 / $810.89	Professional		$513.48	$580.95	$810.89