Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $803.00 / $2,131.00 / $7,513.00	Facility		$803.00	$2,131.00	$7,513.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $629.45 / $677.54 / $910.07	Facility	54	$629.45	$677.54	$910.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.71 / $878.09 / $1,325.17	Professional		$603.71	$878.09	$1,325.17
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.44 / $135.51 / $199.16	Professional	55	$95.44	$135.51	$199.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $758.39 / $800.61 / $1,137.58	Professional		$758.39	$800.61	$1,137.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,863.75 / $5,651.13 / $11,378.62	Facility		$2,863.75	$5,651.13	$11,378.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $733.28 / $910.00 / $1,295.93	Professional		$733.28	$910.00	$1,295.93
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $109.89 / $1,349.91 / $2,378.26	Facility		$109.89	$1,349.91	$2,378.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $789.77 / $926.87 / $1,329.85	Professional		$789.77	$926.87	$1,329.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $704.14 / $3,407.94 / $3,407.94	Facility		$704.14	$3,407.94	$3,407.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,578.19 / $2,578.19 / $2,662.46	Facility		$2,578.19	$2,578.19	$2,662.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $760.58 / $984.90 / $1,389.50	Professional		$760.58	$984.90	$1,389.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $11,500.00 / $12,000.00 / $12,000.00	Facility		$11,500.00	$12,000.00	$12,000.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,318.88 / $7,881.75 / $7,881.75	Facility	54	$1,318.88	$7,881.75	$7,881.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,899.52 / $6,128.88 / $6,737.48	Professional		$5,899.52	$6,128.88	$6,737.48
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $757.70 / $935.69 / $1,335.20	Facility		$757.70	$935.69	$1,335.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $758.39 / $1,021.83 / $1,414.84	Professional		$758.39	$1,021.83	$1,414.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $371.07 / $2,499.00 / $6,094.00	Facility		$371.07	$2,499.00	$6,094.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $714.34 / $783.03 / $886.57	Professional		$714.34	$783.03	$886.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $758.39 / $944.83 / $1,516.62	Facility		$758.39	$944.83	$1,516.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $758.39 / $997.65 / $1,516.79	Professional		$758.39	$997.65	$1,516.79
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $306.38 / $306.38 / $313.64	Professional	55	$306.38	$306.38	$313.64
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 $588.96 / $792.37 / $1,149.09	Professional		$588.96	$792.37	$1,149.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $670.84 / $758.39 / $1,066.19	Professional		$670.84	$758.39	$1,066.19