Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $569.00 / $2,166.00 / $5,216.00	Facility		$569.00	$2,166.00	$5,216.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $52.57 / $89.31 / $143.85	Facility	52	$52.57	$89.31	$143.85
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.59 / $74.05 / $150.21	Facility	53	$29.59	$74.05	$150.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.53 / $249.08 / $565.00	Professional		$137.53	$249.08	$565.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $31.08 / $74.04 / $167.29	Professional	53	$31.08	$74.04	$167.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.46 / $201.21 / $260.19	Professional		$173.46	$201.21	$260.19
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $82.68 / $90.53 / $157.80	Professional	53	$82.68	$90.53	$157.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $679.85 / $1,166.78 / $2,589.55	Facility		$679.85	$1,166.78	$2,589.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.22 / $273.05 / $434.52	Professional		$164.22	$273.05	$434.52
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $195.79 / $546.76 / $2,250.00	Facility		$195.79	$546.76	$2,250.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $179.02 / $363.31	Professional		$51.00	$179.02	$363.31
Christus Facility/Professional Facility Modifier Low / Median / High Price $162.16 / $1,072.36 / $1,072.36	Facility		$162.16	$1,072.36	$1,072.36
Christus Facility/Professional Facility Modifier 53 Low / Median / High Price $81.08 / $81.08 / $183.02	Facility	53	$81.08	$81.08	$183.02
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 $194.94 / $194.94 / $194.94	Facility	52	$194.94	$194.94	$194.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $48.74 / $48.74	Facility	53	$48.74	$48.74	$48.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $301.75 / $301.75	Professional		$301.75	$301.75	$301.75
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $63.86 / $137.13 / $174.72	Professional	53	$63.86	$137.13	$174.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,040.30 / $11,500.00 / $16,394.00	Facility		$1,040.30	$11,500.00	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $664.86 / $717.55 / $717.55	Facility	52	$664.86	$717.55	$717.55
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $166.21 / $179.39 / $179.39	Facility	53	$166.21	$179.39	$179.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,182.76 / $2,208.13 / $2,840.70	Professional		$1,182.76	$2,208.13	$2,840.70
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 $176.99 / $332.14 / $646.46	Facility		$176.99	$332.14	$646.46
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $211.86 / $360.79 / $591.50	Professional		$211.86	$360.79	$591.50
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $170.57 / $1,998.24 / $2,896.00	Facility		$170.57	$1,998.24	$2,896.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.75 / $221.75 / $598.34	Professional		$97.75	$221.75	$598.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $176.99 / $335.92 / $665.47	Facility		$176.99	$335.92	$665.47
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $194.94 / $194.94 / $194.94	Facility	52	$194.94	$194.94	$194.94
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $48.74 / $48.74	Facility	53	$48.74	$48.74	$48.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $301.75 / $811.26	Professional		$301.75	$301.75	$811.26
Providence Facility/Professional Professional Modifier 53 Low / Median / High Price $106.08 / $144.02 / $244.40	Professional	53	$106.08	$144.02	$244.40
United Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $1,513.00 / $3,260.00	Facility		$369.00	$1,513.00	$3,260.00
United Facility/Professional Professional Modifier Low / Median / High Price $276.01 / $385.61 / $616.98	Professional		$276.01	$385.61	$616.98
United Facility/Professional Professional Modifier 53 Low / Median / High Price $204.84 / $204.84 / $204.84	Professional	53	$204.84	$204.84	$204.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $279.93 / $327.33 / $443.96	Professional		$279.93	$327.33	$443.96
Wellpoint Facility/Professional Professional Modifier 53 Low / Median / High Price $139.97 / $204.59 / $299.82	Professional	53	$139.97	$204.59	$299.82