Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.98 / $663.14 / $5,469.00	Facility		$75.98	$663.14	$5,469.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $272.87 / $272.87 / $625.60	Facility	50	$272.87	$272.87	$625.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $75.98 / $181.06	Professional		$43.65	$75.98	$181.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $183.75 / $309.06 / $400.71	Professional	50	$183.75	$309.06	$400.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.01 / $133.77 / $147.37	Professional		$34.01	$133.77	$147.37
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.95 / $112.95 / $112.95	Professional	50	$112.95	$112.95	$112.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.46 / $164.64 / $369.61	Facility		$45.46	$164.64	$369.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $68.26 / $120.96	Professional		$42.36	$68.26	$120.96
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $120.48 / $140.85 / $169.44	Facility		$120.48	$140.85	$169.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $84.33 / $150.60	Professional		$51.77	$84.33	$150.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $40.93 / $46.10 / $46.10	Facility		$40.93	$46.10	$46.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.42 / $92.86 / $190.02	Professional		$52.42	$92.86	$190.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $276.80	Facility		$55.00	$55.00	$276.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $377.00 / $647.52 / $679.95	Professional		$377.00	$647.52	$679.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.06 / $87.35 / $179.15	Facility		$47.06	$87.35	$179.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $60.55 / $86.64 / $136.99	Professional		$60.55	$86.64	$136.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.30 / $107.30 / $107.30	Professional		$107.30	$107.30	$107.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.41 / $88.40 / $190.77	Facility		$47.41	$88.40	$190.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.31 / $96.07 / $205.50	Professional		$54.31	$96.07	$205.50
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 $71.30 / $109.64 / $163.27	Professional		$71.30	$109.64	$163.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.81 / $75.30 / $105.87	Professional		$66.81	$75.30	$105.87