Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $390.50 / $2,496.00 / $7,316.00	Facility		$390.50	$2,496.00	$7,316.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,344.50 / $4,612.24 / $11,051.28	Facility	50	$1,344.50	$4,612.24	$11,051.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $211.86 / $355.39 / $574.91	Professional		$211.86	$355.39	$574.91
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $114.04 / $114.04 / $114.04	Professional	50	$114.04	$114.04	$114.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $109.25 / $218.49	Professional		$103.54	$109.25	$218.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $310.63 / $310.63 / $310.63	Professional	50	$310.63	$310.63	$310.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,565.91 / $3,038.26 / $6,560.33	Facility		$1,565.91	$3,038.26	$6,560.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.35 / $343.61 / $529.07	Professional		$202.35	$343.61	$529.07
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $294.36 / $820.80 / $2,250.00	Facility		$294.36	$820.80	$2,250.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $123.69 / $227.80 / $357.57	Professional		$123.69	$227.80	$357.57
Christus Facility/Professional Facility Modifier Low / Median / High Price $188.30 / $586.50 / $586.50	Facility		$188.30	$586.50	$586.50
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 $229.42 / $377.95 / $599.07	Professional		$229.42	$377.95	$599.07
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,517.16 / $16,394.00 / $16,394.00	Facility		$1,517.16	$16,394.00	$16,394.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,610.24 / $3,064.73 / $3,896.06	Professional		$1,610.24	$3,064.73	$3,896.06
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $221.77 / $384.78 / $669.21	Facility		$221.77	$384.78	$669.21
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $235.54 / $364.02 / $603.77	Professional		$235.54	$364.02	$603.77
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $624.63 / $624.63 / $624.63	Professional	50	$624.63	$624.63	$624.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $206.19 / $347.17 / $444.25	Professional		$206.19	$347.17	$444.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $221.77 / $387.49 / $717.98	Facility		$221.77	$387.49	$717.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $238.15 / $391.12 / $619.84	Professional		$238.15	$391.12	$619.84
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 $318.74 / $433.89 / $652.61	Professional		$318.74	$433.89	$652.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $303.12 / $340.36 / $482.11	Professional		$303.12	$340.36	$482.11