Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,071.00 / $3,896.00 / $12,040.00	Facility		$1,071.00	$3,896.00	$12,040.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,280.79 / $1,493.05 / $2,098.92	Professional		$1,280.79	$1,493.05	$2,098.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,233.66 / $1,307.68 / $1,850.49	Professional		$1,233.66	$1,307.68	$1,850.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,360.13 / $6,032.96 / $12,457.09	Facility		$3,360.13	$6,032.96	$12,457.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,192.23 / $1,476.15 / $2,070.51	Professional		$1,192.23	$1,476.15	$2,070.51
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $3,811.09 / $5,069.04 / $10,579.28	Facility		$3,811.09	$5,069.04	$10,579.28
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $1,275.42 / $1,727.12 / $2,400.00	Professional		$1,275.42	$1,727.12	$2,400.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,088.33 / $4,877.41 / $4,877.41	Facility		$1,088.33	$4,877.41	$4,877.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,235.58 / $3,235.58 / $3,341.33	Facility		$3,235.58	$3,235.58	$3,341.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,309.57 / $1,716.67 / $2,849.32	Professional		$1,309.57	$1,716.67	$2,849.32
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $5,897.00 / $14,907.95	Facility		$55.00	$5,897.00	$14,907.95
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $304.29 / $1,413.06 / $1,413.06	Facility	AS	$304.29	$1,413.06	$1,413.06
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $11,366.67 / $11,366.67 / $11,366.67	Professional		$11,366.67	$11,366.67	$11,366.67
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $1,271.13 / $1,690.16 / $2,742.62	Facility		$1,271.13	$1,690.16	$2,742.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,397.28 / $1,905.38 / $3,240.00	Professional		$1,397.28	$1,905.38	$3,240.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,499.00 / $3,419.00 / $15,296.00	Facility		$2,499.00	$3,419.00	$15,296.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,191.52 / $1,450.49 / $2,542.26	Professional		$1,191.52	$1,450.49	$2,542.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,267.98 / $1,741.87 / $2,983.89	Facility		$1,267.98	$1,741.87	$2,983.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,339.13 / $1,777.63 / $2,814.36	Professional		$1,339.13	$1,777.63	$2,814.36
United Facility/Professional Facility Modifier Low / Median / High Price $2,093.00 / $5,958.00 / $13,134.00	Facility		$2,093.00	$5,958.00	$13,134.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,072.79 / $1,502.59 / $2,288.03	Professional		$1,072.79	$1,502.59	$2,288.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,084.11 / $1,233.66 / $1,721.82	Professional		$1,084.11	$1,233.66	$1,721.82