Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $2,511.89 / $6,918.31	Facility		$537.03	$2,511.89	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $239.88 / $630.96 / $1,230.27	Facility	50	$239.88	$630.96	$1,230.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $371.54 / $724.44	Professional		$288.40	$371.54	$724.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $457.09 / $851.14 / $1,778.28	Professional	50	$457.09	$851.14	$1,778.28
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $239.88 / $380.19 / $630.96	Professional	54	$239.88	$380.19	$630.96
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.10 / $72.44 / $72.44	Professional	55	$63.10	$72.44	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $380.19	Professional		$257.04	$309.03	$380.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $446.68 / $457.09 / $851.14	Professional	50	$446.68	$457.09	$851.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $831.76 / $1,778.28	Facility		$478.63	$831.76	$1,778.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $295.12 / $478.63	Professional		$239.88	$295.12	$478.63
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $588.84 / $1,230.27	Facility		$467.74	$588.84	$1,230.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $354.81 / $537.03	Professional		$173.78	$354.81	$537.03
Christus Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $478.63 / $478.63	Facility		$269.15	$478.63	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $371.54	Facility		$363.08	$363.08	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $398.11 / $616.60	Professional		$302.00	$398.11	$616.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $28,840.32 / $28,840.32	Facility		$1,995.26	$28,840.32	$28,840.32
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility	54	$1,348.96	$1,348.96	$1,348.96
Lucent Health Facility/Professional Facility Modifier 55 Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	55	$288.40	$288.40	$288.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,754.23 / $2,754.23	Professional		$2,398.83	$2,754.23	$2,754.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $446.68 / $3,715.35	Facility		$288.40	$446.68	$3,715.35
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $239.88 / $630.96 / $1,230.27	Facility	50	$239.88	$630.96	$1,230.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $389.05 / $676.08	Professional		$309.03	$389.05	$676.08
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $467.74 / $812.83 / $1,819.70	Professional	50	$467.74	$812.83	$1,819.70
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $239.88 / $288.40 / $549.54	Professional	54	$239.88	$288.40	$549.54
Moda Health Facility/Professional Professional Modifier 55 Low / Median / High Price $56.23 / $56.23 / $72.44	Professional	55	$56.23	$56.23	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $501.19 / $691.83	Professional		$275.42	$501.19	$691.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $371.54 / $676.08	Facility		$281.84	$371.54	$676.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $630.96	Professional		$295.12	$398.11	$630.96
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 $251.19 / $323.59 / $478.63	Professional		$251.19	$323.59	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $338.84	Professional		$323.59	$338.84	$338.84