Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $689.65 / $3,445.00 / $10,836.00	Facility		$689.65	$3,445.00	$10,836.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $894.70 / $2,625.00 / $2,783.38	Facility	50	$894.70	$2,625.00	$2,783.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.08 / $608.88 / $945.27	Professional		$425.08	$608.88	$945.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $210.69 / $365.67 / $731.34	Professional	50	$210.69	$365.67	$731.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $369.66 / $425.78 / $425.78	Professional		$369.66	$425.78	$425.78
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $404.62 / $404.62 / $404.62	Professional	50	$404.62	$404.62	$404.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,666.44 / $3,057.62 / $6,386.16	Facility		$1,666.44	$3,057.62	$6,386.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.07 / $549.15 / $792.36	Professional		$362.07	$549.15	$792.36
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $207.90 / $1,182.04 / $4,050.00	Facility		$207.90	$1,182.04	$4,050.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $489.65 / $598.66 / $894.59	Professional		$489.65	$598.66	$894.59
Christus Facility/Professional Facility Modifier Low / Median / High Price $383.14 / $1,632.25 / $1,632.25	Facility		$383.14	$1,632.25	$1,632.25
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 $456.85 / $657.49 / $950.39	Professional		$456.85	$657.49	$950.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,112.56 / $26,542.00 / $26,542.00	Facility		$3,112.56	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,005.00 / $4,457.92 / $5,124.60	Professional		$4,005.00	$4,457.92	$5,124.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $463.40 / $665.52 / $1,009.54	Facility		$463.40	$665.52	$1,009.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $483.55 / $703.34 / $1,012.89	Professional		$483.55	$703.34	$1,012.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $425.78 / $573.41 / $745.76	Professional		$425.78	$573.41	$745.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $463.40 / $674.40 / $1,081.80	Facility		$463.40	$674.40	$1,081.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $469.26 / $670.05 / $963.23	Professional		$469.26	$670.05	$963.23
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 $470.81 / $618.94 / $938.91	Professional		$470.81	$618.94	$938.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $508.51 / $573.41 / $808.19	Professional		$508.51	$573.41	$808.19