Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $2,187.76 / $6,918.31	Facility		$741.31	$2,187.76	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $741.31 / $1,202.26	Professional		$562.34	$741.31	$1,202.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,148.15 / $1,445.44 / $2,137.96	Professional	50	$1,148.15	$1,445.44	$2,137.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $676.08 / $707.95	Professional		$676.08	$676.08	$707.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $1,348.96 / $2,754.23	Facility		$794.33	$1,348.96	$2,754.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $691.83 / $1,023.29	Professional		$549.54	$691.83	$1,023.29
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $676.08 / $912.01	Professional		$588.84	$676.08	$912.01
Christus Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $707.95	Facility		$512.86	$512.86	$707.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $794.33 / $1,230.27	Professional		$588.84	$794.33	$1,230.27
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,073.80 / $19,498.45 / $19,498.45	Facility		$4,073.80	$19,498.45	$19,498.45
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility	54	$2,884.03	$2,884.03	$2,884.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,011.87 / $5,754.40 / $5,754.40	Professional		$5,011.87	$5,754.40	$5,754.40
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $812.83 / $3,467.37	Facility		$562.34	$812.83	$3,467.37
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $776.25 / $1,258.93	Professional		$588.84	$776.25	$1,258.93
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $1,148.15 / $1,148.15 / $2,137.96	Professional	50	$1,148.15	$1,148.15	$2,137.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $251.19 / $1,348.96	Professional		$32.36	$251.19	$1,348.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Professional		$660.69	$660.69	$660.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $741.31 / $1,174.90	Facility		$562.34	$741.31	$1,174.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $794.33 / $1,258.93	Professional		$588.84	$794.33	$1,258.93
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,511.89 / $4,786.30	Facility		$676.08	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $954.99	Professional		$489.78	$660.69	$954.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $707.95 / $707.95	Professional		$676.08	$707.95	$707.95