Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $882.00 / $3,617.00 / $12,040.00	Facility		$882.00	$3,617.00	$12,040.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,797.91 / $3,797.91 / $3,797.91	Facility	50	$3,797.91	$3,797.91	$3,797.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $565.32 / $702.38 / $1,030.92	Professional		$565.32	$702.38	$1,030.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $379.85 / $379.85 / $600.11	Professional		$379.85	$379.85	$600.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,508.83 / $4,846.93 / $9,318.64	Facility		$2,508.83	$4,846.93	$9,318.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $578.38 / $716.12 / $1,004.46	Professional		$578.38	$716.12	$1,004.46
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $73.33 / $2,301.21 / $4,740.38	Facility		$73.33	$2,301.21	$4,740.38
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $300.06 / $360.07 / $521.85	Professional		$300.06	$360.07	$521.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $539.59 / $539.59 / $563.73	Facility		$539.59	$539.59	$563.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,953.70 / $1,953.70 / $2,017.56	Facility		$1,953.70	$1,953.70	$2,017.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $600.91 / $792.69 / $1,200.22	Professional		$600.91	$792.69	$1,200.22
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,001.70 / $26,542.00 / $26,542.00	Facility		$9,001.70	$26,542.00	$26,542.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,206.00 / $5,206.00 / $5,290.28	Professional		$5,206.00	$5,206.00	$5,290.28
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $589.40 / $749.41 / $1,209.00	Facility		$589.40	$749.41	$1,209.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $600.11 / $805.27 / $1,114.99	Professional		$600.11	$805.27	$1,114.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $536.91 / $673.60 / $1,271.08	Professional		$536.91	$673.60	$1,271.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $589.40 / $767.99 / $1,338.35	Facility		$589.40	$767.99	$1,338.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $600.91 / $823.02 / $1,225.07	Professional		$600.91	$823.02	$1,225.07
United Facility/Professional Facility Modifier Low / Median / High Price $1,634.00 / $4,200.00 / $10,600.00	Facility		$1,634.00	$4,200.00	$10,600.00
United Facility/Professional Professional Modifier Low / Median / High Price $495.99 / $657.55 / $982.83	Professional		$495.99	$657.55	$982.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $528.66 / $600.11 / $839.75	Professional		$528.66	$600.11	$839.75