Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.97 / $3,445.00 / $10,836.00	Facility		$776.97	$3,445.00	$10,836.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,298.00 / $2,461.55 / $9,702.20	Facility	50	$1,298.00	$2,461.55	$9,702.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.99 / $735.40 / $1,135.17	Professional		$519.99	$735.40	$1,135.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $733.32 / $835.47 / $4,506.14	Professional	50	$733.32	$835.47	$4,506.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $554.99 / $554.99 / $599.39	Professional		$554.99	$554.99	$599.39
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $832.48 / $1,010.42 / $1,599.62	Professional	50	$832.48	$1,010.42	$1,599.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,644.92 / $2,999.56 / $6,086.00	Facility		$1,644.92	$2,999.56	$6,086.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $521.84 / $681.80 / $983.85	Professional		$521.84	$681.80	$983.85
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $769.00 / $2,190.60 / $5,199.47	Facility		$769.00	$2,190.60	$5,199.47
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $629.96 / $776.99 / $1,094.85	Professional		$629.96	$776.99	$1,094.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $496.82 / $1,090.21 / $1,090.21	Facility		$496.82	$1,090.21	$1,090.21
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 $591.10 / $816.51 / $1,159.01	Professional		$591.10	$816.51	$1,159.01
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,054.44 / $26,542.00 / $26,542.00	Facility		$4,054.44	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,208.00 / $7,208.00 / $7,208.00	Professional		$7,208.00	$7,208.00	$7,208.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $589.48 / $818.26 / $1,321.39	Facility		$589.48	$818.26	$1,321.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $629.78 / $886.70 / $1,205.91	Professional		$629.78	$886.70	$1,205.91
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $979.91 / $1,031.01 / $1,764.00	Professional	50	$979.91	$1,031.01	$1,764.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $554.83 / $718.50 / $887.93	Professional		$554.83	$718.50	$887.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $589.48 / $819.47 / $1,375.25	Facility		$589.48	$819.47	$1,375.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $602.94 / $829.65 / $1,221.53	Professional		$602.94	$829.65	$1,221.53
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 $566.24 / $754.99 / $1,110.65	Professional		$566.24	$754.99	$1,110.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $605.41 / $684.29 / $961.98	Professional		$605.41	$684.29	$961.98