Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $921.00 / $3,682.00 / $12,281.00	Facility		$921.00	$3,682.00	$12,281.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $565.55 / $615.16 / $717.82	Facility	54	$565.55	$615.16	$717.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $712.12 / $875.54 / $1,371.98	Professional		$712.12	$875.54	$1,371.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $580.05 / $580.05 / $919.61	Professional		$580.05	$580.05	$919.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,249.68 / $5,765.68 / $11,157.22	Facility		$3,249.68	$5,765.68	$11,157.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $491.50 / $588.07 / $964.45	Professional		$491.50	$588.07	$964.45
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,928.08 / $3,874.51 / $6,197.40	Facility		$1,928.08	$3,874.51	$6,197.40
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $602.36 / $692.71 / $986.10	Professional		$602.36	$692.71	$986.10
Christus Facility/Professional Facility Modifier Low / Median / High Price $527.25 / $4,926.04 / $4,926.04	Facility		$527.25	$4,926.04	$4,926.04
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 $615.82 / $1,124.74 / $1,854.43	Professional		$615.82	$1,124.74	$1,854.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $11,879.05	Facility		$55.00	$55.00	$11,879.05
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,005.66 / $7,881.75 / $7,881.75	Facility	54	$1,005.66	$7,881.75	$7,881.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,714.27 / $4,714.27 / $5,129.03	Professional		$4,714.27	$4,714.27	$5,129.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $602.36 / $830.23 / $1,640.97	Facility		$602.36	$830.23	$1,640.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $659.67 / $899.55 / $2,471.40	Professional		$659.67	$899.55	$2,471.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,074.27 / $2,499.00 / $7,290.00	Facility		$1,074.27	$2,499.00	$7,290.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $609.99 / $731.50 / $1,380.13	Professional		$609.99	$731.50	$1,380.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $609.05 / $880.37 / $1,862.91	Facility		$609.05	$880.37	$1,862.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $630.46 / $1,160.13 / $1,795.81	Professional		$630.46	$1,160.13	$1,795.81
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $278.17 / $278.17 / $284.77	Professional	55	$278.17	$278.17	$284.77
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $5,931.00 / $13,134.00	Facility		$2,093.00	$5,931.00	$13,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $728.17 / $1,014.43 / $1,561.15	Professional		$728.17	$1,014.43	$1,561.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $511.83 / $580.05 / $813.19	Professional		$511.83	$580.05	$813.19