Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $2,570.40 / $6,918.31	Facility		$645.65	$2,570.40	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility	50	$1,412.54	$1,412.54	$1,412.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $630.96	Professional		$204.17	$309.03	$630.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $346.74 / $645.65 / $1,174.90	Professional	50	$346.74	$645.65	$1,174.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $229.09 / $288.40	Professional		$181.97	$229.09	$288.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $218.78 / $912.01	Facility		$134.90	$218.78	$912.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $208.93 / $331.13	Professional		$165.96	$208.93	$331.13
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $602.56 / $1,230.27	Facility		$208.93	$602.56	$1,230.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $257.04 / $398.11	Professional		$117.49	$257.04	$398.11
Christus Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $478.63 / $478.63	Facility		$169.82	$478.63	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $165.96	Facility		$162.18	$162.18	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $562.34	Professional		$218.78	$302.00	$562.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $2,951.21	Facility		$54.95	$56.23	$2,951.21
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	54	$977.24	$977.24	$977.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,466.84 / $4,466.84 / $4,466.84	Professional		$4,466.84	$4,466.84	$4,466.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $416.87 / $3,715.35	Facility		$208.93	$416.87	$3,715.35
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,412.54 / $1,412.54 / $1,412.54	Facility	50	$1,412.54	$1,412.54	$1,412.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $288.40 / $512.86	Professional		$204.17	$288.40	$512.86
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $346.74 / $588.84 / $1,023.29	Professional	50	$346.74	$588.84	$1,023.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $281.84	Professional		$32.36	$33.11	$281.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $660.69	Facility		$660.69	$660.69	$660.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $316.23 / $512.86	Professional		$177.83	$316.23	$512.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $323.59 / $602.56	Facility		$204.17	$323.59	$602.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $537.03	Professional		$213.80	$302.00	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,659.59 / $4,168.69	Facility		$407.38	$1,659.59	$4,168.69
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $416.87	Professional		$190.55	$269.15	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $245.47 / $245.47	Professional		$234.42	$245.47	$245.47