Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.18 / $3,596.00 / $10,893.00	Facility		$724.18	$3,596.00	$10,893.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $358.32 / $515.17 / $715.50	Facility	54	$358.32	$515.17	$715.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $411.76 / $626.12 / $1,013.93	Professional		$411.76	$626.12	$1,013.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $447.09 / $473.92 / $670.64	Professional		$447.09	$473.92	$670.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,702.98 / $3,038.26 / $6,192.64	Facility		$1,702.98	$3,038.26	$6,192.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $376.39 / $567.44 / $848.17	Professional		$376.39	$567.44	$848.17
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $946.44 / $2,544.69 / $5,461.00	Facility		$946.44	$2,544.69	$5,461.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $514.15 / $642.69 / $831.59	Professional		$514.15	$642.69	$831.59
Christus Facility/Professional Facility Modifier Low / Median / High Price $403.44 / $1,623.37 / $1,623.37	Facility		$403.44	$1,623.37	$1,623.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,263.04 / $1,263.04 / $1,304.32	Facility		$1,263.04	$1,263.04	$1,304.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $476.10 / $676.19 / $991.20	Professional		$476.10	$676.19	$991.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,271.74 / $26,542.00 / $26,542.00	Facility		$3,271.74	$26,542.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,513.22 / $1,708.32 / $1,708.32	Facility	54	$1,513.22	$1,708.32	$1,708.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,473.76 / $4,783.60 / $5,502.38	Professional		$3,473.76	$4,783.60	$5,502.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $462.01 / $671.19 / $1,024.72	Facility		$462.01	$671.19	$1,024.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $508.10 / $739.06 / $1,087.13	Professional		$508.10	$739.06	$1,087.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $91.91 / $1,560.50 / $1,560.50	Facility		$91.91	$1,560.50	$1,560.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $449.88 / $684.58 / $1,196.32	Professional		$449.88	$684.58	$1,196.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $462.01 / $677.74 / $1,087.47	Facility		$462.01	$677.74	$1,087.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $490.33 / $699.25 / $1,009.62	Professional		$490.33	$699.25	$1,009.62
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,264.00 / $7,600.00	Facility		$1,120.00	$3,264.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $509.68 / $673.33 / $989.28	Professional		$509.68	$673.33	$989.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $545.79 / $614.91 / $867.63	Professional		$545.79	$614.91	$867.63