Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $1,122.02 / $1,380.38	Facility		$549.54	$1,122.02	$1,380.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $741.31	Professional		$549.54	$549.54	$741.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,412.54 / $2,630.27	Facility		$588.84	$1,412.54	$2,630.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $691.83 / $1,047.13	Professional		$575.44	$691.83	$1,047.13
Christus Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Facility		$645.65	$645.65	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $549.54 / $549.54	Facility		$512.86	$549.54	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Facility		$3,467.37	$3,467.37	$3,467.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Professional		$2,884.03	$2,884.03	$2,884.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $562.34 / $1,000.00	Facility		$549.54	$562.34	$1,000.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $676.08	Professional		$549.54	$549.54	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $660.69 / $758.58	Professional		$602.56	$660.69	$758.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $741.31 / $1,122.02	Professional		$0.60	$741.31	$1,122.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $562.34 / $1,000.00	Facility		$549.54	$562.34	$1,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $524.81 / $691.83	Professional		$524.81	$524.81	$691.83
United Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $575.44	Facility		$549.54	$549.54	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $575.44 / $602.56	Professional		$549.54	$575.44	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $676.08	Professional		$549.54	$549.54	$676.08