Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $1,479.11 / $5,495.41	Facility		$354.81	$1,479.11	$5,495.41
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $346.74 / $977.24 / $3,311.31	Facility	50	$346.74	$977.24	$3,311.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $58.88 / $141.25	Professional		$30.20	$58.88	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $30.90 / $52.48	Professional		$23.99	$30.90	$52.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $602.56 / $1,318.26	Facility		$338.84	$602.56	$1,318.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $57.54 / $112.20	Professional		$28.84	$57.54	$112.20
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $223.87 / $1,202.26	Facility		$16.22	$223.87	$1,202.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $69.18	Professional		$30.90	$44.67	$69.18
Christus Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $34.67 / $77.62	Facility		$26.92	$34.67	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $66.07 / $147.91	Professional		$35.48	$66.07	$147.91
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 $1,659.59 / $1,659.59 / $1,659.59	Professional		$1,659.59	$1,659.59	$1,659.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $81.28 / $1,778.28	Facility		$31.62	$81.28	$1,778.28
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $954.99 / $977.24 / $3,311.31	Facility	50	$954.99	$977.24	$3,311.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $66.07 / $154.88	Professional		$30.90	$66.07	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $33.11	Professional		$25.70	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $85.11 / $218.78	Professional		$48.98	$85.11	$218.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $63.10 / $138.04	Facility		$31.62	$63.10	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $69.18 / $154.88	Professional		$37.15	$69.18	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,047.13 / $2,691.53	Facility		$158.49	$1,047.13	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $52.48 / $107.15	Professional		$31.62	$52.48	$107.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $83.18 / $97.72	Professional		$79.43	$83.18	$97.72