Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.93 / $1,934.00 / $6,691.00	Facility		$166.93	$1,934.00	$6,691.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $756.61 / $960.58 / $1,131.05	Facility	50	$756.61	$960.58	$1,131.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.42 / $118.32 / $210.45	Professional		$93.42	$118.32	$210.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $84.33 / $201.62 / $684.75	Professional	50	$84.33	$201.62	$684.75
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $199.08 / $199.08 / $199.08	Professional	50	$199.08	$199.08	$199.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.18 / $95.37 / $379.51	Facility		$56.18	$95.37	$379.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.56 / $131.63 / $201.32	Professional		$100.56	$131.63	$201.32
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $110.75 / $171.65 / $529.39	Facility		$110.75	$171.65	$529.39
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $122.45 / $148.91 / $218.38	Professional		$122.45	$148.91	$218.38
Christus Facility/Professional Facility Modifier Low / Median / High Price $96.71 / $383.92 / $383.92	Facility		$96.71	$383.92	$383.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.13 / $186.13 / $186.13	Facility		$186.13	$186.13	$186.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.24 / $162.63 / $247.21	Professional		$118.24	$162.63	$247.21
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $534.90	Facility		$55.00	$55.00	$534.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $766.56 / $966.30 / $1,209.53	Professional		$766.56	$966.30	$1,209.53
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.37 / $141.21 / $242.95	Facility		$104.37	$141.21	$242.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $140.02 / $182.97 / $243.95	Professional		$140.02	$182.97	$243.95
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $550.46 / $550.46 / $550.46	Professional	50	$550.46	$550.46	$550.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.98 / $159.83 / $224.21	Professional		$116.98	$159.83	$224.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.66 / $142.02 / $248.68	Facility		$105.66	$142.02	$248.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.80 / $167.78 / $261.23	Professional		$120.80	$167.78	$261.23
United Facility/Professional Facility Modifier Low / Median / High Price $161.00 / $950.00 / $2,405.00	Facility		$161.00	$950.00	$2,405.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $137.86 / $225.41	Professional		$103.40	$137.86	$225.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $115.67 / $130.61 / $181.56	Professional		$115.67	$130.61	$181.56