Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $974.27 / $3,774.00 / $13,004.00	Facility		$974.27	$3,774.00	$13,004.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $676.47 / $730.70 / $1,005.89	Facility	54	$676.47	$730.70	$1,005.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.41 / $974.27 / $1,434.55	Professional		$738.41	$974.27	$1,434.55
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $114.35 / $146.13 / $221.60	Professional	55	$114.35	$146.13	$221.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $419.12 / $441.80 / $1,609.45	Professional		$419.12	$441.80	$1,609.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,825.04 / $3,174.32 / $6,490.17	Facility		$1,825.04	$3,174.32	$6,490.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $709.94 / $943.58 / $1,407.95	Professional		$709.94	$943.58	$1,407.95
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $53.16 / $1,081.34 / $4,784.45	Facility		$53.16	$1,081.34	$4,784.45
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $497.27 / $998.18 / $1,508.83	Professional		$497.27	$998.18	$1,508.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $747.54 / $1,372.89 / $1,372.89	Facility		$747.54	$1,372.89	$1,372.89
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 $863.39 / $1,120.25 / $1,659.53	Professional		$863.39	$1,120.25	$1,659.53
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 54 Low / Median / High Price $1,449.79 / $4,569.92 / $4,569.92	Facility	54	$1,449.79	$4,569.92	$4,569.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,516.24 / $6,715.76 / $7,369.65	Professional		$6,516.24	$6,715.76	$7,369.65
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $859.17 / $1,089.71 / $1,723.02	Facility		$859.17	$1,089.71	$1,723.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $950.73 / $1,123.58 / $1,555.74	Professional		$950.73	$1,123.58	$1,555.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $744.13 / $969.98 / $1,984.05	Professional		$744.13	$969.98	$1,984.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $859.17 / $1,104.50 / $1,864.48	Facility		$859.17	$1,104.50	$1,864.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $844.28 / $1,163.96 / $1,717.17	Professional		$844.28	$1,163.96	$1,717.17
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $330.67 / $330.67 / $338.51	Professional	55	$330.67	$330.67	$338.51
United Facility/Professional Facility Modifier Low / Median / High Price $1,120.00 / $3,264.00 / $7,600.00	Facility		$1,120.00	$3,264.00	$7,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $699.29 / $925.34 / $1,381.86	Professional		$699.29	$925.34	$1,381.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $737.65 / $838.24 / $1,171.77	Professional		$737.65	$838.24	$1,171.77