Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $482.72 / $492.18 / $501.65	Facility		$482.72	$492.18	$501.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $454.32 / $501.65 / $813.99	Professional		$454.32	$501.65	$813.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $644.02 / $767.46 / $1,080.93	Professional		$644.02	$767.46	$1,080.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,456.92 / $5,821.21 / $8,577.84	Facility		$5,456.92	$5,821.21	$8,577.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $514.42 / $514.42 / $643.62	Professional		$514.42	$514.42	$643.62
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $756.65 / $810.70 / $1,080.93	Professional		$756.65	$810.70	$1,080.93
Christus Facility/Professional Facility Modifier Low / Median / High Price $1,080.93 / $1,080.93 / $1,080.93	Facility		$1,080.93	$1,080.93	$1,080.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $731.38 / $731.38 / $860.28	Facility		$731.38	$731.38	$860.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $533.91 / $731.38	Professional		$533.91	$533.91	$731.38
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,806.24 / $5,006.71 / $5,006.71	Facility		$1,806.24	$5,006.71	$5,006.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,412.81 / $5,412.81 / $7,870.50	Professional		$5,412.81	$5,412.81	$7,870.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $309.33 / $758.33 / $1,080.93	Facility		$309.33	$758.33	$1,080.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $309.33 / $972.84 / $1,080.93	Professional		$309.33	$972.84	$1,080.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $826.91 / $1,080.93 / $2,480.73	Professional		$826.91	$1,080.93	$2,480.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $309.33 / $731.38 / $1,080.93	Facility		$309.33	$731.38	$1,080.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $533.91 / $533.91 / $860.28	Professional		$533.91	$533.91	$860.28
United Facility/Professional Professional Modifier Low / Median / High Price $399.31 / $577.44 / $687.43	Professional		$399.31	$577.44	$687.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $575.41 / $580.35 / $1,080.93	Professional		$575.41	$580.35	$1,080.93