Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $591.58 / $2,625.00 / $6,279.90	Facility		$591.58	$2,625.00	$6,279.90
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,377.00 / $3,220.50 / $7,323.00	Facility	50	$1,377.00	$3,220.50	$7,323.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.78 / $436.06 / $778.55	Professional		$375.78	$436.06	$778.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $765.81 / $880.76 / $1,211.40	Professional	50	$765.81	$880.76	$1,211.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.88 / $452.43 / $570.82	Professional		$266.88	$452.43	$570.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $315.63 / $631.27 / $1,231.00	Professional	50	$315.63	$631.27	$1,231.00
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 $353.36 / $445.08 / $691.35	Professional		$353.36	$445.08	$691.35
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $356.80 / $1,172.31 / $4,264.18	Facility		$356.80	$1,172.31	$4,264.18
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $239.74 / $312.06 / $490.38	Professional		$239.74	$312.06	$490.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $410.38 / $1,490.38 / $1,490.38	Facility		$410.38	$1,490.38	$1,490.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $742.64 / $742.64 / $742.64	Facility		$742.64	$742.64	$742.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.92 / $582.69 / $881.16	Professional		$441.92	$582.69	$881.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,079.40 / $11,500.00 / $16,394.00	Facility		$2,079.40	$11,500.00	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,829.00 / $4,131.06 / $4,131.06	Professional		$3,829.00	$4,131.06	$4,131.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $410.34 / $513.55 / $896.81	Facility		$410.34	$513.55	$896.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $487.91 / $628.22 / $811.61	Professional		$487.91	$628.22	$811.61
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,271.01 / $1,271.01 / $1,271.01	Professional	50	$1,271.01	$1,271.01	$1,271.01
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $514.30 / $1,453.03 / $5,733.00	Facility		$514.30	$1,453.03	$5,733.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $441.92 / $755.59 / $1,638.74	Professional		$441.92	$755.59	$1,638.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $410.34 / $518.91 / $900.00	Facility		$410.34	$518.91	$900.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $445.27 / $596.90 / $901.27	Professional		$445.27	$596.90	$901.27
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 $339.42 / $457.76 / $727.35	Professional		$339.42	$457.76	$727.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $378.76 / $427.87 / $598.55	Professional		$378.76	$427.87	$598.55