Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $3,235.94 / $11,748.98	Facility		$812.83	$3,235.94	$11,748.98
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,819.70 / $2,570.40 / $3,630.78	Facility	50	$1,819.70	$2,570.40	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $158.49 / $316.23	Professional		$131.83	$158.49	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $4,168.69 / $7,762.47	Facility		$2,089.30	$4,168.69	$7,762.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $173.78 / $239.88	Professional		$138.04	$173.78	$239.88
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $169.82 / $208.93	Professional		$104.71	$169.82	$208.93
Christus Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Facility		$1,995.26	$1,995.26	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $323.59	Professional		$151.36	$199.53	$323.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $7,943.28 / $45,708.82 / $45,708.82	Facility		$7,943.28	$45,708.82	$45,708.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,288.25 / $1,288.25	Professional		$1,096.48	$1,288.25	$1,288.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $302.00 / $4,677.35	Facility		$144.54	$302.00	$4,677.35
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,819.70 / $2,570.40 / $7,943.28	Facility	50	$1,819.70	$2,570.40	$7,943.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $186.21 / $354.81	Professional		$138.04	$186.21	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $123.03	Professional		$32.36	$33.11	$123.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $302.00 / $398.11	Professional		$3.98	$302.00	$398.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $199.53 / $338.84	Facility		$141.25	$199.53	$338.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $323.59	Professional		$151.36	$199.53	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,511.89 / $4,897.79	Facility		$724.44	$2,511.89	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $257.04	Professional		$120.23	$165.96	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25