Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.93 / $1,341.00 / $5,322.00	Facility		$206.93	$1,341.00	$5,322.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.60 / $112.08 / $218.21	Professional		$50.60	$112.08	$218.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.28 / $133.35 / $498.52	Facility		$74.28	$133.35	$498.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $122.41 / $205.33	Professional		$66.34	$122.41	$205.33
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $93.65	Facility		$26.30	$26.30	$93.65
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $152.74 / $202.27 / $256.72	Professional		$152.74	$202.27	$256.72
Christus Facility/Professional Facility Modifier Low / Median / High Price $65.17 / $66.45 / $66.45	Facility		$65.17	$66.45	$66.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.26 / $123.26 / $123.26	Facility		$123.26	$123.26	$123.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.75 / $145.13 / $247.25	Professional		$71.75	$145.13	$247.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $351.41 / $15,000.00	Facility		$55.00	$351.41	$15,000.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,087.00 / $1,126.56 / $1,308.83	Professional		$1,087.00	$1,126.56	$1,308.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.22 / $142.37 / $232.75	Facility		$70.22	$142.37	$232.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $90.83 / $177.57 / $281.57	Professional		$90.83	$177.57	$281.57
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,823.64 / $6,232.93 / $11,490.14	Facility		$4,823.64	$6,232.93	$11,490.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.34 / $155.41 / $311.18	Professional		$72.34	$155.41	$311.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.22 / $143.33 / $229.77	Facility		$70.22	$143.33	$229.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.97 / $149.69 / $266.74	Professional		$72.97	$149.69	$266.74
United Facility/Professional Facility Modifier Low / Median / High Price $374.00 / $1,529.00 / $3,400.00	Facility		$374.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.92 / $141.72 / $224.44	Professional		$103.92	$141.72	$224.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $145.47 / $205.13	Professional		$129.19	$145.47	$205.13