Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $1,905.46 / $7,413.10	Facility		$512.86	$1,905.46	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $724.44 / $1,318.26 / $2,137.96	Facility	50	$724.44	$1,318.26	$2,137.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $89.13 / $269.15	Professional		$47.86	$89.13	$269.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $177.83 / $549.54	Professional	50	$74.13	$177.83	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $79.43 / $112.20	Professional		$44.67	$79.43	$112.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.79 / $120.23 / $162.18	Professional	50	$70.79	$120.23	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $977.24 / $3,801.89	Facility		$190.55	$977.24	$3,801.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $74.13 / $114.82	Professional		$41.69	$74.13	$114.82
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $562.34 / $1,348.96	Facility		$50.12	$562.34	$1,348.96
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $100.00	Professional		$47.86	$69.18	$100.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $309.03 / $309.03	Facility		$43.65	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $97.72 / $169.82	Professional		$56.23	$97.72	$169.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $1,479.11 / $1,698.24	Facility		$741.31	$1,479.11	$1,698.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $120.23 / $3,467.37	Facility		$50.12	$120.23	$3,467.37
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $446.68 / $1,318.26 / $2,511.89	Facility	50	$446.68	$1,318.26	$2,511.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $87.10 / $173.78	Professional		$47.86	$87.10	$173.78
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $177.83 / $549.54	Professional	50	$72.44	$177.83	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $32.36 / $72.44	Professional		$7.08	$32.36	$72.44
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,344.23 / $3,019.95 / $3,388.44	Facility		$2,344.23	$3,019.95	$3,388.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $169.82	Professional		$100.00	$100.00	$169.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $93.33 / $169.82	Facility		$48.98	$93.33	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $95.50 / $169.82	Professional		$56.23	$95.50	$169.82
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 $45.71 / $75.86 / $131.83	Professional		$45.71	$75.86	$131.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $97.72 / $97.72	Professional		$91.20	$97.72	$97.72