Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $696.00 / $2,768.00 / $7,495.00	Facility		$696.00	$2,768.00	$7,495.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,693.25 / $2,693.25 / $2,693.25	Facility	50	$2,693.25	$2,693.25	$2,693.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $496.66 / $649.34 / $940.04	Professional		$496.66	$649.34	$940.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $592.25 / $592.25 / $1,079.93	Professional		$592.25	$592.25	$1,079.93
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 $540.78 / $669.57 / $939.16	Professional		$540.78	$669.57	$939.16
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $147.18 / $820.80 / $2,250.00	Facility		$147.18	$820.80	$2,250.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $291.20 / $349.88 / $519.71	Professional		$291.20	$349.88	$519.71
Christus Facility/Professional Facility Modifier Low / Median / High Price $232.06 / $232.06 / $504.66	Facility		$232.06	$232.06	$504.66
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 $561.41 / $733.63 / $1,123.70	Professional		$561.41	$733.63	$1,123.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,819.45 / $16,394.00 / $16,394.00	Facility		$5,819.45	$16,394.00	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,166.30 / $5,166.30 / $5,166.30	Professional		$5,166.30	$5,166.30	$5,166.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $570.61 / $701.96 / $1,064.32	Facility		$570.61	$701.96	$1,064.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $561.85 / $799.85 / $1,043.95	Professional		$561.85	$799.85	$1,043.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $543.98 / $615.41 / $697.43	Professional		$543.98	$615.41	$697.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $565.42 / $718.64 / $1,155.94	Facility		$565.42	$718.64	$1,155.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $561.85 / $767.16 / $1,145.43	Professional		$561.85	$767.16	$1,145.43
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 $464.09 / $616.04 / $918.92	Professional		$464.09	$616.04	$918.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $494.99 / $561.85 / $786.24	Professional		$494.99	$561.85	$786.24