Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $104.71 / $245.47	Facility		$26.30	$104.71	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $295.12	Professional		$102.33	$138.04	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $275.42	Professional		$100.00	$125.89	$275.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $251.19 / $398.11	Facility		$102.33	$251.19	$398.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $144.54 / $169.82	Professional		$51.29	$144.54	$169.82
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $138.04 / $269.15	Facility		$114.82	$138.04	$269.15
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $204.17	Professional		$91.20	$117.49	$204.17
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 $144.54 / $380.19 / $512.86	Facility		$144.54	$380.19	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $316.23	Professional		$107.15	$162.18	$316.23
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Facility		$1,023.29	$1,023.29	$1,023.29
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $1,023.29 / $1,318.26	Professional		$194.98	$1,023.29	$1,318.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $151.36 / $295.12	Facility		$102.33	$151.36	$295.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $316.23	Professional		$104.71	$147.91	$316.23
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 $173.78 / $616.60 / $691.83	Facility		$173.78	$616.60	$691.83
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 $120.23 / $181.97 / $380.19	Facility		$120.23	$181.97	$380.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $275.42	Professional		$104.71	$154.88	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $257.04	Professional		$128.82	$165.96	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $199.53	Professional		$158.49	$158.49	$199.53