Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $323.59 / $1,096.48	Facility		$100.00	$323.59	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $194.98	Professional		$93.33	$128.82	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $407.38 / $676.08	Facility		$162.18	$407.38	$676.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $181.97 / $794.33	Facility		$102.33	$181.97	$794.33
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $144.54 / $275.42	Professional		$93.33	$144.54	$275.42
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $97.72 / $97.72	Facility		$79.43	$97.72	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $407.38 / $794.33	Facility		$128.82	$407.38	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $281.84	Professional		$107.15	$138.04	$281.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility		$1,122.02	$1,122.02	$1,122.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $851.14 / $1,047.13 / $1,047.13	Professional		$851.14	$1,047.13	$1,047.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $138.04 / $346.74	Facility		$81.28	$138.04	$346.74
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $223.87	Professional		$91.20	$131.83	$223.87
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 Professional Modifier Low / Median / High Price $125.89 / $158.49 / $281.84	Professional		$125.89	$158.49	$281.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $144.54 / $467.74	Facility		$87.10	$144.54	$467.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $263.03	Professional		$102.33	$138.04	$263.03
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $162.18 / $213.80	Facility		$87.10	$162.18	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $154.88 / $229.09	Professional		$123.03	$154.88	$229.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $81.28	Professional		$77.62	$77.62	$81.28