Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $3,467.37 / $10,964.78	Facility		$794.33	$3,467.37	$10,964.78
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,230.27 / $3,890.45 / $8,912.51	Facility	50	$1,230.27	$3,890.45	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $173.78 / $398.11	Professional		$138.04	$173.78	$398.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $398.11 / $891.25	Professional	50	$162.18	$398.11	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $151.36 / $208.93	Professional		$81.28	$151.36	$208.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $194.98 / $234.42 / $426.58	Professional	50	$194.98	$234.42	$426.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,137.96 / $4,466.84	Facility		$1,258.93	$2,137.96	$4,466.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $181.97 / $251.19	Professional		$144.54	$181.97	$251.19
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $2,089.30 / $6,456.54	Facility		$630.96	$2,089.30	$6,456.54
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $109.65 / $218.78	Professional		$91.20	$109.65	$218.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,096.48 / $1,096.48	Facility		$141.25	$1,096.48	$1,096.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $213.80 / $346.74	Professional		$162.18	$213.80	$346.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $45,708.82 / $45,708.82	Facility		$3,715.35	$45,708.82	$45,708.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Professional		$1,445.44	$1,445.44	$1,445.44
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $588.84 / $6,025.60	Facility		$154.88	$588.84	$6,025.60
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $1,202.26 / $4,168.69 / $8,912.51	Facility	50	$1,202.26	$4,168.69	$8,912.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $194.98 / $371.54	Professional		$141.25	$194.98	$371.54
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $363.08 / $891.25	Professional	50	$162.18	$363.08	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $128.82	Professional		$32.36	$33.11	$128.82
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,951.21 / $4,677.35	Facility		$2,511.89	$2,951.21	$4,677.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $323.59 / $407.38	Professional		$3.98	$323.59	$407.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $213.80 / $363.08	Facility		$147.91	$213.80	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $213.80 / $346.74	Professional		$162.18	$213.80	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $2,511.89 / $4,786.30	Facility		$724.44	$2,511.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $275.42	Professional		$128.82	$177.83	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $147.91 / $147.91	Professional		$138.04	$147.91	$147.91