Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,454.00 / $8,180.00 / $24,267.98	Facility		$1,454.00	$8,180.00	$24,267.98
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $137.16 / $175.07 / $209.80	Facility	53	$137.16	$175.07	$209.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $685.81 / $984.63 / $1,621.01	Professional		$685.81	$984.63	$1,621.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $814.88 / $888.54 / $955.42	Professional		$814.88	$888.54	$955.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $20,367.74 / $51,845.16 / $99,519.76	Facility		$20,367.74	$51,845.16	$99,519.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $804.45 / $1,083.71 / $1,561.84	Professional		$804.45	$1,083.71	$1,561.84
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $1,067.48 / $29,503.36 / $56,507.70	Facility		$1,067.48	$29,503.36	$56,507.70
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $876.22 / $1,210.05 / $1,538.23	Professional		$876.22	$1,210.05	$1,538.23
Christus Facility/Professional Facility Modifier Low / Median / High Price $791.66 / $20,851.99 / $20,851.99	Facility		$791.66	$20,851.99	$20,851.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11,347.00 / $25,761.00 / $55,914.00	Facility		$11,347.00	$25,761.00	$55,914.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,044.85 / $1,421.56 / $2,093.44	Professional		$1,044.85	$1,421.56	$2,093.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $9,427.54 / $26,727.00 / $26,727.00	Facility		$9,427.54	$26,727.00	$26,727.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $407.91 / $5,345.40 / $5,345.40	Facility	53	$407.91	$5,345.40	$5,345.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,806.64 / $6,806.64 / $7,877.55	Professional		$6,806.64	$6,806.64	$7,877.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $875.85 / $1,094.18 / $2,498.38	Facility		$875.85	$1,094.18	$2,498.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $1,165.65 / $1,344.98 / $1,700.00	Professional		$1,165.65	$1,344.98	$1,700.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,087.08 / $1,250.35 / $1,592.93	Professional		$1,087.08	$1,250.35	$1,592.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $876.22 / $1,095.28 / $2,557.30	Facility		$876.22	$1,095.28	$2,557.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,040.16 / $1,433.13 / $2,336.94	Professional		$1,040.16	$1,433.13	$2,336.94
United Facility/Professional Facility Modifier Low / Median / High Price $5,327.00 / $13,049.00 / $27,000.00	Facility		$5,327.00	$13,049.00	$27,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $926.84 / $1,211.63 / $1,966.38	Professional		$926.84	$1,211.63	$1,966.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $765.26 / $876.22 / $1,200.29	Professional		$765.26	$876.22	$1,200.29