Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $325.52 / $2,276.00 / $5,499.78	Facility		$325.52	$2,276.00	$5,499.78
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $52.49 / $89.21 / $143.78	Facility	52	$52.49	$89.21	$143.78
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.56 / $73.90 / $150.03	Facility	53	$29.56	$73.90	$150.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.80 / $248.93 / $504.09	Professional		$133.80	$248.93	$504.09
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $31.04 / $72.51 / $166.49	Professional	53	$31.04	$72.51	$166.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.16 / $184.60 / $259.74	Professional		$173.16	$184.60	$259.74
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $110.68 / $110.68 / $110.68	Professional	53	$110.68	$110.68	$110.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $679.85 / $1,199.29 / $2,589.55	Facility		$679.85	$1,199.29	$2,589.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.82 / $272.79 / $434.09	Professional		$162.82	$272.79	$434.09
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $177.43 / $294.36 / $1,777.75	Facility		$177.43	$294.36	$1,777.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $216.45 / $398.50	Professional		$50.92	$216.45	$398.50
Christus Facility/Professional Facility Modifier Low / Median / High Price $161.86 / $844.53 / $844.53	Facility		$161.86	$844.53	$844.53
Christus Facility/Professional Facility Modifier 53 Low / Median / High Price $80.78 / $80.78 / $182.72	Facility	53	$80.78	$80.78	$182.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $529.61 / $702.60 / $2,213.00	Facility		$529.61	$702.60	$2,213.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.61 / $194.61 / $194.61	Facility	52	$194.61	$194.61	$194.61
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.65 / $48.65 / $48.65	Facility	53	$48.65	$48.65	$48.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $301.45	Professional		$301.45	$301.45	$301.45
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $63.86 / $137.13 / $174.41	Professional	53	$63.86	$137.13	$174.41
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,038.84 / $11,500.00 / $16,394.00	Facility		$1,038.84	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $663.66 / $716.72 / $716.72	Facility	52	$663.66	$716.72	$716.72
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $165.92 / $179.18 / $179.18	Facility	53	$165.92	$179.18	$179.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,182.00 / $2,206.53 / $2,836.73	Professional		$1,182.00	$2,206.53	$2,836.73
Lucent Health Facility/Professional Professional Modifier 53 Low / Median / High Price $119.55 / $119.55 / $251.32	Professional	53	$119.55	$119.55	$251.32
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $176.94 / $331.24 / $638.32	Facility		$176.94	$331.24	$638.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $207.93 / $376.82 / $589.80	Professional		$207.93	$376.82	$589.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $170.57 / $1,215.00 / $2,896.00	Facility		$170.57	$1,215.00	$2,896.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $221.52 / $601.51	Professional		$97.44	$221.52	$601.51
Providence Facility/Professional Facility Modifier Low / Median / High Price $176.72 / $335.46 / $665.47	Facility		$176.72	$335.46	$665.47
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $194.61 / $194.61 / $194.61	Facility	52	$194.61	$194.61	$194.61
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $48.65 / $48.65 / $48.65	Facility	53	$48.65	$48.65	$48.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $810.71	Professional		$301.45	$301.45	$810.71
Providence Facility/Professional Professional Modifier 53 Low / Median / High Price $106.08 / $143.83 / $244.21	Professional	53	$106.08	$143.83	$244.21
United Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $1,500.00 / $3,260.00	Facility		$369.00	$1,500.00	$3,260.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.91 / $382.00 / $608.83	Professional		$280.91	$382.00	$608.83
United Facility/Professional Professional Modifier 53 Low / Median / High Price $204.61 / $204.61 / $204.61	Professional	53	$204.61	$204.61	$204.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $279.66 / $327.05 / $443.58	Professional		$279.66	$327.05	$443.58
Wellpoint Facility/Professional Professional Modifier 53 Low / Median / High Price $139.69 / $204.23 / $299.25	Professional	53	$139.69	$204.23	$299.25