Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $969.00 / $3,766.00 / $13,004.00	Facility		$969.00	$3,766.00	$13,004.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $640.08 / $691.78 / $955.37	Facility	54	$640.08	$691.78	$955.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.10 / $929.55 / $1,356.62	Professional		$761.10	$929.55	$1,356.62
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $109.71 / $138.36 / $195.84	Professional	55	$109.71	$138.36	$195.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,986.00 / $6,673.28 / $13,304.06	Facility		$3,986.00	$6,673.28	$13,304.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $754.00 / $935.73 / $1,332.56	Professional		$754.00	$935.73	$1,332.56
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $823.42 / $955.37 / $1,472.86	Professional		$823.42	$955.37	$1,472.86
Christus Facility/Professional Facility Modifier Low / Median / High Price $704.36 / $2,686.68 / $2,686.68	Facility		$704.36	$2,686.68	$2,686.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,632.24 / $4,632.24 / $4,783.64	Facility		$4,632.24	$4,632.24	$4,783.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $838.84 / $1,060.65 / $1,592.27	Professional		$838.84	$1,060.65	$1,592.27
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $21,343.05	Facility		$55.00	$55.00	$21,343.05
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,375.68 / $14,161.14 / $14,161.14	Facility	54	$1,375.68	$14,161.14	$14,161.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,188.96 / $6,370.48 / $6,982.88	Professional		$6,188.96	$6,370.48	$6,982.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $796.14 / $948.65 / $1,592.49	Facility		$796.14	$948.65	$1,592.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $796.14 / $1,065.97 / $1,393.97	Professional		$796.14	$1,065.97	$1,393.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $716.81 / $871.07 / $1,532.10	Professional		$716.81	$871.07	$1,532.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $796.46 / $955.37 / $1,633.48	Facility		$796.46	$955.37	$1,633.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $838.84 / $1,097.39 / $1,625.23	Professional		$838.84	$1,097.39	$1,625.23
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $313.08 / $313.08 / $320.51	Professional	55	$313.08	$313.08	$320.51
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $5,931.00 / $13,134.00	Facility		$2,093.00	$5,931.00	$13,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $669.92 / $893.22 / $1,417.86	Professional		$669.92	$893.22	$1,417.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $699.83 / $796.14 / $1,111.61	Professional		$699.83	$796.14	$1,111.61