Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.03 / $2,068.00 / $6,762.00	Facility		$336.03	$2,068.00	$6,762.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $177.52 / $228.14 / $317.51	Facility	54	$177.52	$228.14	$317.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.86 / $304.18 / $510.26	Professional		$227.86	$304.18	$510.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $269.81 / $442.29 / $742.89	Professional	50	$269.81	$442.29	$742.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $169.37 / $228.14 / $354.60	Professional	54	$169.37	$228.14	$354.60
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $33.86 / $45.63 / $70.92	Professional	55	$33.86	$45.63	$70.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.92 / $274.55 / $351.17	Professional		$218.92	$274.55	$351.17
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $444.78 / $444.78 / $444.78	Professional	50	$444.78	$444.78	$444.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.42 / $290.44 / $1,161.76	Facility		$170.42	$290.44	$1,161.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.05 / $271.16 / $390.37	Professional		$186.05	$271.16	$390.37
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $261.18 / $361.22 / $482.86	Professional		$261.18	$361.22	$482.86
Christus Facility/Professional Facility Modifier Low / Median / High Price $197.40 / $228.10 / $290.10	Facility		$197.40	$228.10	$290.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $222.19 / $222.19 / $229.45	Facility		$222.19	$222.19	$229.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.67 / $346.06 / $627.72	Professional		$242.67	$346.06	$627.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,933.96	Facility		$55.00	$55.00	$1,933.96
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $740.71 / $836.14 / $836.14	Facility	54	$740.71	$836.14	$836.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,831.00 / $2,831.00 / $2,831.00	Professional		$2,831.00	$2,831.00	$2,831.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $238.47 / $370.44 / $657.23	Facility		$238.47	$370.44	$657.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $255.37 / $356.21 / $595.73	Professional		$255.37	$356.21	$595.73
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $635.80 / $635.80 / $635.80	Professional	50	$635.80	$635.80	$635.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $58.90 / $326.70 / $1,000.00	Facility		$58.90	$326.70	$1,000.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $219.33 / $312.30 / $556.40	Professional		$219.33	$312.30	$556.40
Providence Facility/Professional Facility Modifier Low / Median / High Price $237.51 / $375.12 / $671.82	Facility		$237.51	$375.12	$671.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $247.52 / $359.41 / $604.75	Professional		$247.52	$359.41	$604.75
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $443.76 / $443.76 / $454.29	Professional	54	$443.76	$443.76	$454.29
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $110.94 / $110.94 / $113.57	Professional	55	$110.94	$110.94	$113.57
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 $240.03 / $324.16 / $520.88	Professional		$240.03	$324.16	$520.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $243.21 / $274.55 / $386.63	Professional		$243.21	$274.55	$386.63