Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $4,073.80 / $12,882.50	Facility		$1,000.00	$4,073.80	$12,882.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,471.29 / $10,471.29 / $38,018.94	Facility	50	$10,471.29	$10,471.29	$38,018.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $977.24 / $2,041.74	Professional		$707.95	$977.24	$2,041.74
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $537.03 / $977.24 / $1,071.52	Professional	54	$537.03	$977.24	$1,071.52
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $69.18 / $169.82 / $229.09	Professional	55	$69.18	$169.82	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $691.83 / $891.25	Professional		$467.74	$691.83	$891.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,235.94 / $6,456.54	Facility		$1,905.46	$3,235.94	$6,456.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $1,122.02	Professional		$537.03	$676.08	$1,122.02
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,454.71 / $6,025.60	Facility		$1,202.26	$2,454.71	$6,025.60
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $977.24 / $1,258.93	Professional		$707.95	$977.24	$1,258.93
Christus Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,737.80 / $1,737.80	Facility		$616.60	$1,737.80	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $977.24 / $1,698.24	Professional		$724.44	$977.24	$1,698.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,918.31 / $33,884.42 / $33,884.42	Facility		$6,918.31	$33,884.42	$33,884.42
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $4,786.30 / $4,786.30 / $4,786.30	Facility	54	$4,786.30	$4,786.30	$4,786.30
Lucent Health Facility/Professional Facility Modifier 55 Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility	55	$1,023.29	$1,023.29	$1,023.29
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,918.31 / $6,918.31 / $6,918.31	Professional		$6,918.31	$6,918.31	$6,918.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,380.38 / $7,413.10	Facility		$691.83	$1,380.38	$7,413.10
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $10,471.29 / $10,471.29 / $38,018.94	Facility	50	$10,471.29	$10,471.29	$38,018.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $933.25 / $1,737.80	Professional		$741.31	$933.25	$1,737.80
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $602.56 / $1,071.52 / $3,890.45	Professional	54	$602.56	$1,071.52	$3,890.45
Moda Health Facility/Professional Professional Modifier 55 Low / Median / High Price $69.18 / $169.82 / $831.76	Professional	55	$69.18	$169.82	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,819.70	Professional		$32.36	$33.11	$1,819.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $5,370.32 / $5,495.41	Facility		$3,388.44	$5,370.32	$5,495.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $724.44 / $1,412.54	Professional		$616.60	$724.44	$1,412.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $1,071.52 / $1,819.70	Facility		$691.83	$1,071.52	$1,819.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,000.00 / $1,698.24	Professional		$724.44	$1,000.00	$1,698.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $3,981.07 / $8,709.64	Facility		$1,258.93	$3,981.07	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $870.96 / $1,318.26	Professional		$616.60	$870.96	$1,318.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $645.65 / $645.65	Professional		$616.60	$645.65	$645.65