Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.28 / $924.00 / $5,322.00	Facility		$137.28	$924.00	$5,322.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.78 / $102.52 / $201.49	Professional		$58.78	$102.52	$201.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.51 / $44.35 / $64.93	Professional	52	$28.51	$44.35	$64.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.69 / $105.15 / $142.83	Professional		$95.69	$105.15	$142.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.31 / $274.33 / $594.08	Facility		$122.31	$274.33	$594.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $91.29 / $145.27	Professional		$57.00	$91.29	$145.27
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $63.97 / $121.91 / $653.87	Facility		$63.97	$121.91	$653.87
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $39.06 / $84.12 / $158.13	Professional		$39.06	$84.12	$158.13
Christus Facility/Professional Facility Modifier Low / Median / High Price $60.31 / $94.72 / $104.76	Facility		$60.31	$94.72	$104.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.56 / $112.51 / $172.11	Professional		$70.56	$112.51	$172.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $362.43	Facility		$55.00	$55.00	$362.43
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $181.98 / $818.56 / $951.75	Professional		$181.98	$818.56	$951.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $62.35 / $101.37 / $154.57	Facility		$62.35	$101.37	$154.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.00 / $135.19 / $204.56	Professional		$83.00	$135.19	$204.56
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $24.33 / $24.33 / $31.64	Facility		$24.33	$24.33	$31.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $103.30 / $132.47	Professional		$63.26	$103.30	$132.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.45 / $101.76 / $155.44	Facility		$62.45	$101.76	$155.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.29 / $118.05 / $204.96	Professional		$72.29	$118.05	$204.96
United Facility/Professional Facility Modifier Low / Median / High Price $152.88 / $949.00 / $2,376.00	Facility		$152.88	$949.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $114.40 / $171.99	Professional		$85.80	$114.40	$171.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.86 / $105.15 / $147.21	Professional		$93.86	$105.15	$147.21