Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.31 / $2,080.00 / $7,513.00	Facility		$175.31	$2,080.00	$7,513.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $697.11 / $697.11 / $1,000.50	Facility	50	$697.11	$697.11	$1,000.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.40 / $135.31 / $204.90	Professional		$100.40	$135.31	$204.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.06 / $195.48 / $931.50	Professional	50	$85.06	$195.48	$931.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.63 / $132.93 / $238.72	Professional		$123.63	$132.93	$238.72
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $185.44 / $185.44 / $358.08	Professional	50	$185.44	$185.44	$358.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.37 / $126.97 / $510.22	Facility		$73.37	$126.97	$510.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.50 / $134.80 / $196.98	Professional		$106.50	$134.80	$196.98
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $133.01 / $329.35 / $392.97	Facility		$133.01	$329.35	$392.97
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $63.01 / $84.37 / $114.98	Professional		$63.01	$84.37	$114.98
Christus Facility/Professional Facility Modifier Low / Median / High Price $101.74 / $101.74 / $135.79	Facility		$101.74	$101.74	$135.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.34 / $102.34 / $105.68	Facility		$102.34	$102.34	$105.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.03 / $150.16 / $225.43	Professional		$113.03	$150.16	$225.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $804.54	Facility		$55.00	$55.00	$804.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $852.40 / $1,199.94 / $1,199.94	Professional		$852.40	$1,199.94	$1,199.94
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $98.82 / $141.69 / $225.52	Facility		$98.82	$141.69	$225.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $109.57 / $160.53 / $205.47	Professional		$109.57	$160.53	$205.47
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $221.67 / $255.93 / $301.39	Professional	50	$221.67	$255.93	$301.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $110.88 / $133.43 / $161.32	Professional		$110.88	$133.43	$161.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.10 / $142.08 / $229.95	Facility		$100.10	$142.08	$229.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $153.43 / $239.31	Professional		$115.65	$153.43	$239.31
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $950.00 / $2,376.00	Facility		$157.00	$950.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.20 / $133.53 / $205.82	Professional		$99.20	$133.53	$205.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.60 / $123.63 / $174.23	Professional		$109.60	$123.63	$174.23