Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $2,630.27 / $6,606.93	Facility		$630.96	$2,630.27	$6,606.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $2,951.21 / $7,244.36	Facility	50	$1,380.38	$2,951.21	$7,244.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $501.19 / $1,174.90	Professional		$380.19	$501.19	$1,174.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $724.44 / $1,202.26 / $1,905.46	Professional	50	$724.44	$1,202.26	$1,905.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $436.52 / $676.08	Professional		$239.88	$436.52	$676.08
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $588.84 / $776.25 / $933.25	Professional	50	$588.84	$776.25	$933.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $2,630.27 / $5,370.32	Facility		$1,584.89	$2,630.27	$5,370.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $676.08	Professional		$363.08	$436.52	$676.08
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $758.58 / $1,862.09	Facility		$147.91	$758.58	$1,862.09
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $691.83	Professional		$239.88	$354.81	$691.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,548.82 / $1,548.82	Facility		$407.38	$1,548.82	$1,548.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $588.84 / $912.01	Professional		$436.52	$588.84	$912.01
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $28,840.32 / $28,840.32	Facility		$5,248.07	$28,840.32	$28,840.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,168.69 / $4,168.69 / $4,168.69	Professional		$4,168.69	$4,168.69	$4,168.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $660.69 / $4,265.80	Facility		$426.58	$660.69	$4,265.80
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,819.70 / $3,548.13 / $8,128.31	Facility	50	$1,819.70	$3,548.13	$8,128.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $562.34 / $933.25	Professional		$380.19	$562.34	$933.25
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $758.58 / $1,202.26 / $1,584.89	Professional	50	$758.58	$1,202.26	$1,584.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $407.38	Professional		$32.36	$33.11	$407.38
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $5,370.32 / $5,623.41	Facility		$3,388.44	$5,370.32	$5,623.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,584.89 / $1,819.70	Professional		$831.76	$1,584.89	$1,819.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $562.34 / $977.24	Facility		$416.87	$562.34	$977.24
Providence Facility/Professional Facility Modifier 22 Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	22	$891.25	$891.25	$891.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $912.01	Professional		$416.87	$588.84	$912.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.38 / $4,073.80 / $8,912.51	Facility		$1,380.38	$4,073.80	$8,912.51
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $457.09 / $707.95	Professional		$338.84	$457.09	$707.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $489.78 / $489.78	Professional		$467.74	$489.78	$489.78