Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $81.28 / $186.21	Facility		$26.30	$81.28	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $234.42	Professional		$69.18	$114.82	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $97.72 / $218.78	Professional		$89.13	$97.72	$218.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $263.03 / $398.11	Facility		$120.23	$263.03	$398.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $158.49 / $186.21	Professional		$56.23	$158.49	$186.21
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $162.18	Facility		$125.89	$125.89	$162.18
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $162.18 / $218.78	Professional		$64.57	$162.18	$218.78
Christus Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Facility		$30.20	$30.20	$30.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $338.84 / $501.19	Facility		$117.49	$338.84	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $295.12	Professional		$104.71	$162.18	$295.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $1,047.13 / $1,047.13	Professional		$181.97	$1,047.13	$1,047.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $125.89 / $239.88	Facility		$81.28	$125.89	$239.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $128.82 / $257.04	Professional		$81.28	$128.82	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $44.67	Professional		$30.20	$30.20	$44.67
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $831.76 / $1,000.00	Facility		$194.98	$831.76	$1,000.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $56.23 / $83.18	Professional		$22.91	$56.23	$83.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $144.54 / $323.59	Facility		$95.50	$144.54	$323.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $281.84	Professional		$104.71	$147.91	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $239.88	Professional		$114.82	$158.49	$239.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $158.49	Professional		$125.89	$125.89	$158.49