Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $2,754.23 / $7,413.10	Facility		$707.95	$2,754.23	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,318.26 / $1,318.26 / $2,630.27	Facility	50	$1,318.26	$1,318.26	$2,630.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $275.42 / $602.56	Professional		$154.88	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $281.84 / $338.84 / $912.01	Professional	50	$281.84	$338.84	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $245.47 / $288.40	Professional		$72.44	$245.47	$288.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $316.23 / $1,258.93	Facility		$190.55	$316.23	$1,258.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $223.87 / $338.84	Professional		$125.89	$223.87	$338.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $263.03 / $446.68	Professional		$102.33	$263.03	$446.68
Christus Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $245.47 / $269.15	Facility		$131.83	$245.47	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $281.84 / $467.74	Professional		$162.18	$281.84	$467.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $3,890.45	Facility		$478.63	$478.63	$3,890.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Professional		$2,290.87	$2,290.87	$2,290.87
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $338.84 / $3,890.45	Facility		$151.36	$338.84	$3,890.45
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,318.26 / $1,318.26 / $2,630.27	Facility	50	$1,318.26	$1,318.26	$2,630.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $288.40 / $524.81	Professional		$158.49	$288.40	$524.81
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $213.80 / $338.84 / $707.95	Professional	50	$213.80	$338.84	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $234.42	Professional		$32.36	$33.11	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $263.03 / $323.59	Professional		$144.54	$263.03	$323.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $275.42 / $457.09	Facility		$144.54	$275.42	$457.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $281.84 / $467.74	Professional		$162.18	$281.84	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,511.89 / $4,786.30	Facility		$676.08	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $223.87 / $363.08	Professional		$138.04	$223.87	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84