Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.32 / $2,299.00 / $6,940.00	Facility		$269.32	$2,299.00	$6,940.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,403.69 / $1,403.69 / $14,917.28	Facility	50	$1,403.69	$1,403.69	$14,917.28
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $153.53 / $200.78 / $281.51	Facility	54	$153.53	$200.78	$281.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.71 / $271.49 / $412.45	Professional		$204.71	$271.49	$412.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $416.31 / $587.26 / $635.69	Professional	50	$416.31	$587.26	$635.69
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $153.53 / $208.16 / $368.98	Professional	54	$153.53	$208.16	$368.98
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $29.41 / $39.85 / $58.91	Professional	55	$29.41	$39.85	$58.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $191.41 / $236.23 / $341.22	Professional		$191.41	$236.23	$341.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $322.32 / $550.46 / $656.46	Professional	50	$322.32	$550.46	$656.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.28 / $201.60 / $786.54	Facility		$129.28	$201.60	$786.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.91 / $236.22 / $364.38	Professional		$185.91	$236.22	$364.38
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $209.09 / $604.44 / $802.94	Facility		$209.09	$604.44	$802.94
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $226.71 / $306.57 / $403.05	Professional		$226.71	$306.57	$403.05
Christus Facility/Professional Facility Modifier Low / Median / High Price $168.10 / $476.04 / $476.04	Facility		$168.10	$476.04	$476.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.87 / $160.87 / $166.13	Facility		$160.87	$160.87	$166.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.75 / $296.43 / $533.89	Professional		$211.75	$296.43	$533.89
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,436.04	Facility		$55.00	$55.00	$1,436.04
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $645.34 / $720.56 / $720.56	Facility	54	$645.34	$720.56	$720.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,680.00 / $4,509.17 / $4,509.17	Professional		$3,680.00	$4,509.17	$4,509.17
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $206.84 / $344.76 / $617.29	Facility		$206.84	$344.76	$617.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $227.45 / $301.39 / $442.17	Professional		$227.45	$301.39	$442.17
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $609.65 / $609.65 / $609.65	Professional	50	$609.65	$609.65	$609.65
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $38.86 / $215.62 / $660.00	Facility		$38.86	$215.62	$660.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $187.62 / $252.99 / $456.32	Professional		$187.62	$252.99	$456.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $204.73 / $344.84 / $624.67	Facility		$204.73	$344.84	$624.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $227.48 / $308.67 / $521.13	Professional		$227.48	$308.67	$521.13
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $363.31 / $363.31 / $371.93	Professional	54	$363.31	$363.31	$371.93
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $90.83 / $90.83 / $92.98	Professional	55	$90.83	$90.83	$92.98
United Facility/Professional Facility Modifier Low / Median / High Price $371.00 / $1,529.00 / $3,287.00	Facility		$371.00	$1,529.00	$3,287.00
United Facility/Professional Professional Modifier Low / Median / High Price $201.82 / $282.57 / $428.86	Professional		$201.82	$282.57	$428.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $200.70 / $227.48 / $318.91	Professional		$200.70	$227.48	$318.91