Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $461.50 / $2,128.00 / $6,189.00	Facility		$461.50	$2,128.00	$6,189.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $239.64 / $1,243.49 / $1,243.49	Facility	50	$239.64	$1,243.49	$1,243.49
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $234.98 / $253.70 / $356.94	Facility	54	$234.98	$253.70	$356.94
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $47.00 / $50.74 / $71.39	Facility	55	$47.00	$50.74	$71.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.57 / $346.82 / $578.77	Professional		$267.57	$346.82	$578.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.08 / $603.69 / $2,346.00	Professional	50	$436.08	$603.69	$2,346.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $200.68 / $272.82 / $392.69	Professional	54	$200.68	$272.82	$392.69
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $40.14 / $53.57 / $78.54	Professional	55	$40.14	$53.57	$78.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $286.73 / $308.31 / $483.80	Professional		$286.73	$308.31	$483.80
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $453.89 / $499.46 / $843.69	Professional	50	$453.89	$499.46	$843.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $456.24 / $806.02 / $1,789.46	Facility		$456.24	$806.02	$1,789.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $246.02 / $316.77 / $487.90	Professional		$246.02	$316.77	$487.90
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $471.23 / $604.44 / $2,456.26	Facility		$471.23	$604.44	$2,456.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $165.21 / $331.71 / $524.13	Professional		$165.21	$331.71	$524.13
Christus Facility/Professional Facility Modifier Low / Median / High Price $267.80 / $477.43 / $477.43	Facility		$267.80	$477.43	$477.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $362.56 / $362.56 / $374.41	Facility		$362.56	$362.56	$374.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.14 / $392.36 / $577.29	Professional		$291.14	$392.36	$577.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,765.45 / $16,394.00 / $16,394.00	Facility		$1,765.45	$16,394.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $979.13 / $1,117.09 / $1,117.09	Facility	54	$979.13	$1,117.09	$1,117.09
Lucent Health Facility/Professional Facility Modifier 55 Low / Median / High Price $209.81 / $239.38 / $239.38	Facility	55	$209.81	$239.38	$239.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,245.28 / $2,492.32 / $2,743.50	Professional		$2,245.28	$2,492.32	$2,743.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $275.86 / $369.25 / $676.17	Facility		$275.86	$369.25	$676.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $328.77 / $399.89 / $575.84	Professional		$328.77	$399.89	$575.84
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $522.17 / $546.89 / $563.78	Professional	50	$522.17	$546.89	$563.78
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $263.10 / $263.10 / $263.10	Professional	54	$263.10	$263.10	$263.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $47.12 / $261.36 / $800.00	Facility		$47.12	$261.36	$800.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $286.52 / $354.74 / $612.94	Professional		$286.52	$354.74	$612.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $276.48 / $369.97 / $692.12	Facility		$276.48	$369.97	$692.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $304.27 / $400.82 / $613.38	Professional		$304.27	$400.82	$613.38
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $493.35 / $493.35 / $505.05	Professional	54	$493.35	$493.35	$505.05
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $123.34 / $123.34 / $126.26	Professional	55	$123.34	$123.34	$126.26
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 $254.43 / $339.24 / $505.42	Professional		$254.43	$339.24	$505.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $273.02 / $308.31 / $434.08	Professional		$273.02	$308.31	$434.08