Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $1,348.96 / $6,025.60	Facility		$181.97	$1,348.96	$6,025.60
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $380.19 / $812.83 / $2,454.71	Facility	50	$380.19	$812.83	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $131.83 / $309.03	Professional		$54.95	$131.83	$309.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $316.23 / $562.34	Professional	50	$218.78	$316.23	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $144.54 / $234.42	Professional		$48.98	$144.54	$234.42
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $151.36 / $416.87	Professional	50	$36.31	$151.36	$416.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $181.97 / $398.11	Facility		$97.72	$181.97	$398.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $120.23 / $194.98	Professional		$45.71	$120.23	$194.98
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $26.92	Facility		$26.92	$26.92	$26.92
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $75.86 / $208.93	Professional		$48.98	$75.86	$208.93
Christus Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $56.23 / $56.23	Facility		$48.98	$56.23	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $128.82 / $234.42	Professional		$61.66	$128.82	$234.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $1,288.25	Facility		$54.95	$56.23	$1,288.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,318.26 / $1,318.26	Professional		$1,122.02	$1,318.26	$1,318.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $177.83 / $2,818.38	Facility		$63.10	$177.83	$2,818.38
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $380.19 / $912.01 / $5,370.32	Facility	50	$380.19	$912.01	$5,370.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $138.04 / $302.00	Professional		$54.95	$138.04	$302.00
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $288.40 / $562.34	Professional	50	$208.93	$288.40	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $114.82	Professional		$32.36	$33.11	$114.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $194.98 / $426.58	Professional		$5.01	$194.98	$426.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $117.49 / $239.88	Facility		$57.54	$117.49	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $128.82 / $245.47	Professional		$61.66	$128.82	$245.47
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 $52.48 / $93.33 / $186.21	Professional		$52.48	$93.33	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $165.96 / $165.96	Professional		$158.49	$165.96	$165.96