Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $662.60 / $3,481.00 / $10,893.00	Facility		$662.60	$3,481.00	$10,893.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,212.17 / $3,799.50 / $3,799.50	Facility	50	$2,212.17	$3,799.50	$3,799.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.62 / $614.10 / $921.11	Professional		$428.62	$614.10	$921.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $996.27 / $996.27 / $996.27	Professional	50	$996.27	$996.27	$996.27
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $672.31 / $672.31 / $672.31	Professional	50	$672.31	$672.31	$672.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,664.27 / $3,057.62 / $6,214.00	Facility		$1,664.27	$3,057.62	$6,214.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.56 / $573.98 / $899.40	Professional		$436.56	$573.98	$899.40
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $464.12 / $537.85 / $672.32	Professional		$464.12	$537.85	$672.32
Christus Facility/Professional Facility Modifier Low / Median / High Price $400.01 / $1,639.93 / $1,639.93	Facility		$400.01	$1,639.93	$1,639.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,263.04 / $1,263.04 / $1,304.32	Facility		$1,263.04	$1,263.04	$1,304.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $476.62 / $664.28 / $983.44	Professional		$476.62	$664.28	$983.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,274.32 / $26,542.00 / $26,542.00	Facility		$3,274.32	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,569.00 / $7,569.00 / $7,569.00	Professional		$7,569.00	$7,569.00	$7,569.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $481.43 / $685.54 / $1,148.38	Facility		$481.43	$685.54	$1,148.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $508.45 / $723.35 / $983.76	Professional		$508.45	$723.35	$983.76
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $832.37 / $832.37 / $832.37	Professional	50	$832.37	$832.37	$832.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $446.30 / $582.39 / $725.10	Professional		$446.30	$582.39	$725.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $481.43 / $697.67 / $1,219.36	Facility		$481.43	$697.67	$1,219.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $487.87 / $675.05 / $1,006.67	Professional		$487.87	$675.05	$1,006.67
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 $460.14 / $619.83 / $955.74	Professional		$460.14	$619.83	$955.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $493.89 / $558.25 / $784.88	Professional		$493.89	$558.25	$784.88