Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.90 / $291.45 / $680.00	Facility		$53.90	$291.45	$680.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $263.70 / $308.06 / $844.83	Facility	50	$263.70	$308.06	$844.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.14 / $61.17 / $111.83	Professional		$37.14	$61.17	$111.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $114.57 / $114.57 / $114.57	Professional	50	$114.57	$114.57	$114.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.85 / $68.70 / $108.67	Professional		$42.85	$68.70	$108.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.18 / $172.27 / $389.24	Facility		$91.18	$172.27	$389.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.20 / $53.54 / $85.20	Professional		$36.20	$53.54	$85.20
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $19.14 / $48.20 / $51.55	Facility		$19.14	$48.20	$51.55
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $38.59 / $59.69 / $112.03	Professional		$38.59	$59.69	$112.03
Christus Facility/Professional Facility Modifier Low / Median / High Price $39.88 / $44.45 / $44.45	Facility		$39.88	$44.45	$44.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.02 / $68.02 / $68.02	Facility		$68.02	$68.02	$68.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $72.36 / $118.24	Professional		$44.36	$72.36	$118.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $207.77	Facility		$55.00	$55.00	$207.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $294.48 / $497.28 / $585.60	Professional		$294.48	$497.28	$585.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $40.69 / $67.45 / $112.77	Facility		$40.69	$67.45	$112.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $51.55 / $78.92 / $120.09	Professional		$51.55	$78.92	$120.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $662.00 / $879.00 / $1,418.00	Facility		$662.00	$879.00	$1,418.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.19 / $77.18 / $155.90	Professional		$42.19	$77.18	$155.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.53 / $67.14 / $100.72	Facility		$40.53	$67.14	$100.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.25 / $75.65 / $125.73	Professional		$45.25	$75.65	$125.73
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $2,405.00	Facility		$161.00	$950.00	$2,405.00
United Facility/Professional Professional Modifier Low / Median / High Price $49.86 / $67.94 / $105.86	Professional		$49.86	$67.94	$105.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.42 / $64.44 / $91.10	Professional		$57.42	$64.44	$91.10