Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $1,819.70 / $6,309.57	Facility		$269.15	$1,819.70	$6,309.57
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $257.04 / $645.65 / $2,398.83	Facility	50	$257.04	$645.65	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $190.55 / $407.38	Professional		$64.57	$190.55	$407.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $251.19 / $977.24	Professional	50	$165.96	$251.19	$977.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $102.33 / $309.03	Professional		$58.88	$102.33	$309.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $338.84 / $338.84 / $338.84	Professional	50	$338.84	$338.84	$338.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $2,630.27 / $4,265.80	Facility		$1,023.29	$2,630.27	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $158.49 / $288.40	Professional		$61.66	$158.49	$288.40
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $169.82 / $208.93	Facility		$67.61	$169.82	$208.93
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $371.54	Professional		$70.79	$109.65	$371.54
Christus Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $112.20 / $112.20	Facility		$57.54	$112.20	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $186.21 / $407.38	Professional		$75.86	$186.21	$407.38
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 $1,862.09 / $1,862.09 / $3,311.31	Professional		$1,862.09	$1,862.09	$3,311.31
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $229.09 / $933.25	Facility		$66.07	$229.09	$933.25
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $22.39 / $676.08 / $2,884.03	Facility	50	$22.39	$676.08	$2,884.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $190.55 / $436.52	Professional		$64.57	$190.55	$436.52
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $489.78 / $741.31	Professional	50	$165.96	$489.78	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $53.70 / $199.53	Professional		$32.36	$53.70	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $239.88 / $501.19	Professional		$61.66	$239.88	$501.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $199.53 / $436.52	Facility		$64.57	$199.53	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $177.83 / $416.87	Professional		$75.86	$177.83	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $1,047.13 / $2,691.53	Facility		$154.88	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $162.18 / $316.23	Professional		$64.57	$162.18	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $275.42	Professional		$223.87	$234.42	$275.42