Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.44 / $1,341.00 / $5,635.00	Facility		$149.44	$1,341.00	$5,635.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $666.60 / $809.87 / $1,598.24	Facility	50	$666.60	$809.87	$1,598.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.26 / $117.38 / $195.23	Professional		$87.26	$117.38	$195.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.16 / $181.46 / $209.63	Professional	50	$158.16	$181.46	$209.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.27 / $111.42 / $158.34	Professional		$86.27	$111.42	$158.34
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $129.41 / $167.05 / $237.51	Professional	50	$129.41	$167.05	$237.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.50 / $74.70 / $289.35	Facility		$43.50	$74.70	$289.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.01 / $103.65 / $152.33	Professional		$72.01	$103.65	$152.33
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $93.68 / $365.45 / $476.28	Facility		$93.68	$365.45	$476.28
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $62.69 / $125.37 / $196.29	Professional		$62.69	$125.37	$196.29
Christus Facility/Professional Facility Modifier Low / Median / High Price $74.22 / $299.19 / $299.19	Facility		$74.22	$299.19	$299.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.08 / $72.08 / $74.43	Facility		$72.08	$72.08	$74.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.78 / $129.66 / $303.63	Professional		$95.78	$129.66	$303.63
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,169.94	Facility		$55.00	$55.00	$1,169.94
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $503.76 / $1,700.65 / $3,253.02	Professional		$503.76	$1,700.65	$3,253.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.38 / $151.47 / $394.17	Facility		$93.38	$151.47	$394.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $110.79 / $141.81 / $281.08	Professional		$110.79	$141.81	$281.08
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $184.55 / $223.54 / $538.85	Professional	50	$184.55	$223.54	$538.85
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $201.61 / $2,499.00 / $3,923.00	Facility		$201.61	$2,499.00	$3,923.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.59 / $114.47 / $177.44	Professional		$82.59	$114.47	$177.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.12 / $151.72 / $394.17	Facility		$93.12	$151.72	$394.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.16 / $133.71 / $264.88	Professional		$101.16	$133.71	$264.88
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $919.00 / $2,287.00	Facility		$157.00	$919.00	$2,287.00
United Facility/Professional Professional Modifier Low / Median / High Price $82.58 / $113.54 / $235.01	Professional		$82.58	$113.54	$235.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $105.53 / $147.76	Professional		$93.04	$105.53	$147.76