Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $2,290.87 / $6,918.31	Facility		$524.81	$2,290.87	$6,918.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $263.03	Professional		$114.82	$147.91	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $194.98 / $371.54	Professional		$131.83	$194.98	$371.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $151.36 / $660.69	Facility		$91.20	$151.36	$660.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $204.17	Professional		$120.23	$151.36	$204.17
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $134.90	Professional		$128.82	$128.82	$134.90
Christus Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $223.87 / $223.87	Facility		$128.82	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $288.40	Professional		$131.83	$177.83	$288.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $3,890.45	Facility		$54.95	$56.23	$3,890.45
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $549.54 / $549.54 / $549.54	Facility	54	$549.54	$549.54	$549.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,258.93 / $1,258.93	Professional		$1,071.52	$1,258.93	$1,258.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $181.97 / $1,995.26	Facility		$128.82	$181.97	$1,995.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $288.40	Professional		$117.49	$177.83	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $107.15 / $131.83	Professional		$32.36	$107.15	$131.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $489.78 / $588.84	Professional		$158.49	$489.78	$588.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $169.82 / $288.40	Facility		$123.03	$169.82	$288.40
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	54	$151.36	$151.36	$151.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $177.83 / $288.40	Professional		$128.82	$177.83	$288.40
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 $104.71 / $141.25 / $213.80	Professional		$104.71	$141.25	$213.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $158.49 / $158.49	Professional		$151.36	$158.49	$158.49