Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $1,995.26 / $6,918.31	Facility		$346.74	$1,995.26	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $331.13 / $707.95 / $933.25	Facility	50	$331.13	$707.95	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $218.78	Professional		$54.95	$87.10	$218.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $223.87 / $489.78	Professional	50	$114.82	$223.87	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $81.28 / $100.00	Professional		$45.71	$81.28	$100.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $123.03 / $173.78	Professional	50	$75.86	$123.03	$173.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $61.66 / $263.03	Facility		$38.90	$61.66	$263.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $104.71	Professional		$50.12	$70.79	$104.71
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $41.69 / $165.96	Facility		$27.54	$41.69	$165.96
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $97.72 / $141.25	Professional		$58.88	$97.72	$141.25
Christus Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $251.19 / $251.19	Facility		$48.98	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $151.36	Professional		$61.66	$91.20	$151.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $2,951.21	Facility		$54.95	$56.23	$2,951.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $707.95 / $707.95	Professional		$630.96	$707.95	$707.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $95.50 / $1,995.26	Facility		$56.23	$95.50	$1,995.26
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $331.13 / $588.84 / $933.25	Facility	50	$331.13	$588.84	$933.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $158.49	Professional		$54.95	$85.11	$158.49
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $229.09 / $436.52	Professional	50	$123.03	$229.09	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $72.44	Professional		$32.36	$47.86	$72.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $181.97 / $331.13	Professional		$147.91	$181.97	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $87.10 / $151.36	Facility		$54.95	$87.10	$151.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $151.36	Professional		$60.26	$91.20	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $1,047.13 / $2,691.53	Facility		$162.18	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $112.20	Professional		$50.12	$70.79	$112.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $91.20 / $91.20	Professional		$85.11	$91.20	$91.20