Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.25 / $1,665.00 / $6,179.12	Facility		$221.25	$1,665.00	$6,179.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.67 / $214.27 / $365.85	Professional		$126.67	$214.27	$365.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $243.90 / $258.52 / $378.05	Professional		$243.90	$258.52	$378.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.32 / $237.33 / $988.07	Facility		$124.32	$237.33	$988.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.35 / $233.95 / $350.31	Professional		$133.35	$233.95	$350.31
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $140.55 / $140.55 / $328.52	Facility		$140.55	$140.55	$328.52
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $122.23 / $164.64 / $259.04	Professional		$122.23	$164.64	$259.04
Christus Facility/Professional Facility Modifier Low / Median / High Price $126.40 / $167.24 / $250.34	Facility		$126.40	$167.24	$250.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.72 / $262.66 / $391.87	Professional		$161.72	$262.66	$391.87
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,020.66	Facility		$55.00	$55.00	$1,020.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,061.68 / $1,887.12 / $2,204.03	Professional		$1,061.68	$1,887.12	$2,204.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $136.41 / $227.66 / $349.88	Facility		$136.41	$227.66	$349.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $177.90 / $284.64 / $457.63	Professional		$177.90	$284.64	$457.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $132.07 / $238.72 / $305.04	Professional		$132.07	$238.72	$305.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $136.41 / $227.66 / $353.24	Facility		$136.41	$227.66	$353.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $166.82 / $272.26 / $444.69	Professional		$166.82	$272.26	$444.69
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $949.00 / $2,376.00	Facility		$161.00	$949.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.98 / $259.48 / $383.95	Professional		$191.98	$259.48	$383.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $216.99 / $243.90 / $341.46	Professional		$216.99	$243.90	$341.46