Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $2,187.76 / $6,918.31	Facility		$537.03	$2,187.76	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $776.25 / $1,513.56 / $2,511.89	Facility	50	$776.25	$1,513.56	$2,511.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $181.97	Professional		$47.86	$83.18	$181.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $177.83 / $416.87	Professional	50	$79.43	$177.83	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $69.18 / $125.89	Professional		$43.65	$69.18	$125.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.79 / $134.90 / $239.88	Professional	50	$70.79	$134.90	$239.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $380.19 / $3,801.89	Facility		$169.82	$380.19	$3,801.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $112.20	Professional		$41.69	$72.44	$112.20
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $1,202.26 / $5,011.87	Facility		$51.29	$1,202.26	$5,011.87
Christus Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $316.23 / $316.23	Facility		$44.67	$316.23	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $169.82	Professional		$57.54	$97.72	$169.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $323.59	Facility		$54.95	$56.23	$323.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Professional		$2,511.89	$2,511.89	$2,511.89
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $114.82 / $2,951.21	Facility		$50.12	$114.82	$2,951.21
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $776.25 / $1,513.56 / $2,511.89	Facility	50	$776.25	$1,513.56	$2,511.89
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $85.11 / $177.83	Professional		$48.98	$85.11	$177.83
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $173.78 / $501.19	Professional	50	$79.43	$173.78	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $32.36 / $72.44	Professional		$7.24	$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 $102.33 / $102.33 / $169.82	Professional		$102.33	$102.33	$169.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $95.50 / $169.82	Facility		$48.98	$95.50	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $97.72 / $169.82	Professional		$56.23	$97.72	$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 $95.50 / $100.00 / $100.00	Professional		$95.50	$100.00	$100.00