Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $983.00 / $4,077.00 / $10,234.00	Facility		$983.00	$4,077.00	$10,234.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,773.75 / $9,063.00 / $9,063.00	Facility	50	$4,773.75	$9,063.00	$9,063.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $108.66 / $117.34 / $161.90	Facility	53	$108.66	$117.34	$161.90
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $407.48 / $440.03 / $607.12	Facility	54	$407.48	$440.03	$607.12
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $81.50 / $88.01 / $121.42	Facility	55	$81.50	$88.01	$121.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $509.27 / $660.80 / $2,580.30	Professional		$509.27	$660.80	$2,580.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $4,329.68 / $4,329.68 / $4,329.68	Professional	50	$4,329.68	$4,329.68	$4,329.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $254.64 / $329.31 / $473.04	Professional	52	$254.64	$329.31	$473.04
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $381.95 / $493.96 / $703.76	Professional	54	$381.95	$493.96	$703.76
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $76.39 / $95.19 / $141.49	Professional	55	$76.39	$95.19	$141.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $479.31 / $539.76 / $708.30	Professional		$479.31	$539.76	$708.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.67 / $3,174.32 / $6,490.17	Facility		$1,819.67	$3,174.32	$6,490.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $428.05 / $512.16 / $828.92	Professional		$428.05	$512.16	$828.92
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,077.00 / $2,246.46 / $5,937.90	Facility		$1,077.00	$2,246.46	$5,937.90
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $288.22 / $532.46 / $878.56	Professional		$288.22	$532.46	$878.56
Christus Facility/Professional Facility Modifier Low / Median / High Price $452.96 / $1,695.29 / $1,695.29	Facility		$452.96	$1,695.29	$1,695.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,494.86 / $1,494.86 / $1,543.72	Facility		$1,494.86	$1,494.86	$1,543.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $536.59 / $729.64 / $1,351.75	Professional		$536.59	$729.64	$1,351.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,887.55 / $26,542.00 / $26,542.00	Facility		$6,887.55	$26,542.00	$26,542.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $250.20 / $1,305.69 / $1,305.69	Facility	53	$250.20	$1,305.69	$1,305.69
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $875.69 / $4,569.92 / $4,569.92	Facility	54	$875.69	$4,569.92	$4,569.92
Lucent Health Facility/Professional Facility Modifier 55 Low / Median / High Price $187.65 / $979.27 / $979.27	Facility	55	$187.65	$979.27	$979.27
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,762.00 / $6,076.05 / $6,276.56	Professional		$5,762.00	$6,076.05	$6,276.56
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $539.78 / $833.79 / $2,197.90	Facility		$539.78	$833.79	$2,197.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $586.70 / $795.37 / $1,321.46	Professional		$586.70	$795.37	$1,321.46
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $975.48 / $975.48 / $975.48	Professional	50	$975.48	$975.48	$975.48
Moda Health Facility/Professional Professional Modifier 54 Low / Median / High Price $418.51 / $576.72 / $712.25	Professional	54	$418.51	$576.72	$712.25
Moda Health Facility/Professional Professional Modifier 55 Low / Median / High Price $7.84 / $7.84 / $7.84	Professional	55	$7.84	$7.84	$7.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $461.66 / $2,740.00 / $5,733.00	Facility		$461.66	$2,740.00	$5,733.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $461.38 / $554.41 / $982.01	Professional		$461.38	$554.41	$982.01
Providence Facility/Professional Facility Modifier Low / Median / High Price $532.46 / $812.65 / $1,577.87	Facility		$532.46	$812.65	$1,577.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $539.62 / $738.89 / $1,300.08	Professional		$539.62	$738.89	$1,300.08
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $796.45 / $796.45 / $815.34	Professional	54	$796.45	$796.45	$815.34
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $199.11 / $199.11 / $203.83	Professional	55	$199.11	$199.11	$203.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,201.00 / $4,063.00 / $8,226.00	Facility		$1,201.00	$4,063.00	$8,226.00
United Facility/Professional Professional Modifier Low / Median / High Price $473.94 / $641.22 / $971.30	Professional		$473.94	$641.22	$971.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $445.30 / $505.93 / $707.45	Professional		$445.30	$505.93	$707.45