Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.55 / $1,181.00 / $5,469.00	Facility		$74.55	$1,181.00	$5,469.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $15.76 / $37.31	Professional		$12.34	$15.76	$37.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.83 / $36.18 / $95.15	Professional	50	$21.83	$36.18	$95.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $6.19 / $7.28 / $10.77	Professional	52	$6.19	$7.28	$10.77
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $2.48 / $2.91 / $4.29	Professional	53	$2.48	$2.91	$4.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.36 / $14.36 / $46.68	Professional		$13.36	$14.36	$46.68
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $18.30 / $21.45 / $31.79	Professional	50	$18.30	$21.45	$31.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.36 / $88.57 / $196.39	Facility		$53.36	$88.57	$196.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.31 / $15.59 / $24.42	Professional		$12.31	$15.59	$24.42
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $14.53 / $66.40 / $100.49	Facility		$14.53	$66.40	$100.49
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $15.80 / $21.60 / $26.71	Professional		$15.80	$21.60	$26.71
Christus Facility/Professional Facility Modifier Low / Median / High Price $16.23 / $18.32 / $18.32	Facility		$16.23	$18.32	$18.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.63 / $18.45 / $28.51	Professional		$14.63	$18.45	$28.51
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $85.45	Facility		$55.00	$55.00	$85.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $111.04 / $116.72 / $134.18	Professional		$111.04	$116.72	$134.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $14.30 / $16.98 / $30.57	Facility		$14.30	$16.98	$30.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $16.72 / $23.26 / $27.36	Professional		$16.72	$23.26	$27.36
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $13.95 / $24.13 / $67.16	Professional	50	$13.95	$24.13	$67.16
Moda Health Facility/Professional Professional Modifier 53 Low / Median / High Price $2.34 / $2.34 / $2.34	Professional	53	$2.34	$2.34	$2.34
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $364.00 / $465.00 / $638.00	Facility		$364.00	$465.00	$638.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.36 / $15.86 / $17.30	Professional		$14.36	$15.86	$17.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $14.30 / $17.28 / $39.47	Facility		$14.30	$17.28	$39.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $18.75 / $30.52	Professional		$14.70	$18.75	$30.52
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $950.00 / $2,376.00	Facility		$157.00	$950.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $10.83 / $15.16 / $24.55	Professional		$10.83	$15.16	$24.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $14.36 / $20.61	Professional		$12.97	$14.36	$20.61