Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $3,715.35 / $12,882.50	Facility		$1,096.48	$3,715.35	$12,882.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility	50	$1,905.46	$1,905.46	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,122.02 / $1,995.26	Professional		$758.58	$1,122.02	$1,995.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $3,162.28 / $6,309.57	Facility		$1,737.80	$3,162.28	$6,309.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,479.11	Professional		$891.25	$1,122.02	$1,479.11
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $891.25 / $2,511.89	Facility		$75.86	$891.25	$2,511.89
Christus Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $891.25	Facility		$851.14	$851.14	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,318.26	Facility		$1,258.93	$1,258.93	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $1,174.90 / $1,819.70	Professional		$870.96	$1,174.90	$1,819.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,606.93 / $42,657.95 / $42,657.95	Facility		$6,606.93	$42,657.95	$42,657.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,079.46 / $8,128.31 / $8,128.31	Professional		$7,079.46	$8,128.31	$8,128.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $1,348.96 / $6,309.57	Facility		$912.01	$1,348.96	$6,309.57
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,905.46 / $1,905.46 / $1,905.46	Facility	50	$1,905.46	$1,905.46	$1,905.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,174.90 / $1,819.70	Professional		$912.01	$1,174.90	$1,819.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $2,511.89	Professional		$32.36	$33.11	$2,511.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $977.24 / $1,071.52	Professional		$831.76	$977.24	$1,071.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,122.02 / $1,778.28	Facility		$891.25	$1,122.02	$1,778.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,174.90 / $1,819.70	Professional		$851.14	$1,174.90	$1,819.70
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $4,073.80 / $8,709.64	Facility		$1,258.93	$4,073.80	$8,709.64
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $933.25 / $1,348.96	Professional		$691.83	$933.25	$1,348.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $891.25 / $891.25	Professional		$851.14	$891.25	$891.25