Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $3,090.30 / $11,748.98	Facility		$707.95	$3,090.30	$11,748.98
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $933.25 / $2,398.83 / $4,786.30	Facility	50	$933.25	$2,398.83	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $194.98 / $407.38	Professional		$123.03	$194.98	$407.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $436.52 / $1,230.27	Professional	50	$295.12	$436.52	$1,230.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $194.98 / $281.84	Professional		$173.78	$194.98	$281.84
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $257.04 / $302.00 / $380.19	Professional	50	$257.04	$302.00	$380.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $213.80 / $933.25	Facility		$128.82	$213.80	$933.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $177.83 / $288.40	Professional		$123.03	$177.83	$288.40
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $575.44 / $758.58	Facility		$218.78	$575.44	$758.58
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $190.55 / $269.15	Professional		$125.89	$190.55	$269.15
Christus Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $478.63 / $478.63	Facility		$117.49	$478.63	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $371.54	Professional		$141.25	$223.87	$371.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $56.23 / $2,951.21	Facility		$54.95	$56.23	$2,951.21
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,698.24 / $1,698.24	Professional		$1,445.44	$1,698.24	$1,698.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $257.04 / $3,801.89	Facility		$134.90	$257.04	$3,801.89
Moda Health Facility/Professional Facility Modifier 50 Low / Median / High Price $933.25 / $933.25 / $1,513.56	Facility	50	$933.25	$933.25	$1,513.56
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $199.53 / $380.19	Professional		$123.03	$199.53	$380.19
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $436.52 / $1,230.27	Professional	50	$295.12	$436.52	$1,230.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $162.18	Professional		$32.36	$33.11	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $426.58 / $537.03	Professional		$3.98	$426.58	$537.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $213.80 / $380.19	Facility		$128.82	$213.80	$380.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $371.54	Professional		$141.25	$223.87	$371.54
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 $117.49 / $181.97 / $302.00	Professional		$117.49	$181.97	$302.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $204.17 / $204.17	Professional		$194.98	$204.17	$204.17