Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.35 / $1,791.00 / $7,079.02	Facility		$158.35	$1,791.00	$7,079.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.20 / $83.90 / $185.25	Professional		$47.20	$83.90	$185.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.94 / $97.47 / $130.00	Professional		$85.94	$97.47	$130.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.96 / $87.14 / $463.76	Facility		$50.96	$87.14	$463.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $86.58 / $141.43	Professional		$44.88	$86.58	$141.43
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $36.25 / $50.07 / $52.35	Facility		$36.25	$50.07	$52.35
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $58.10 / $120.78 / $176.94	Professional		$58.10	$120.78	$176.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $101.91 / $164.08	Professional		$55.55	$101.91	$164.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $245.67	Facility		$55.00	$55.00	$245.67
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $460.00 / $784.48 / $906.45	Professional		$460.00	$784.48	$906.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $52.71 / $100.51 / $173.87	Facility		$52.71	$100.51	$173.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.49 / $117.68 / $183.98	Professional		$63.49	$117.68	$183.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,125.21 / $1,125.21 / $1,463.25	Facility		$1,125.21	$1,125.21	$1,463.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.45 / $82.30 / $135.04	Professional		$61.45	$82.30	$135.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $53.19 / $101.11 / $178.31	Facility		$53.19	$101.11	$178.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.90 / $105.73 / $170.27	Professional		$55.90	$105.73	$170.27
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $1,058.00 / $2,668.00	Facility		$161.00	$1,058.00	$2,668.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $93.83 / $151.35	Professional		$63.95	$93.83	$151.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.73 / $101.11 / $142.52	Professional		$89.73	$101.11	$142.52