Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $812.83 / $2,089.30	Facility		$213.80	$812.83	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $478.63	Professional		$169.82	$234.42	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $457.09 / $660.69	Professional		$416.87	$457.09	$660.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,621.81 / $2,691.53	Facility		$616.60	$1,621.81	$2,691.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Professional		$177.83	$177.83	$177.83
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $912.01 / $1,230.27	Facility		$489.78	$912.01	$1,230.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $436.52 / $549.54	Professional		$251.19	$436.52	$549.54
Christus Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $371.54	Facility		$331.13	$331.13	$371.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $776.25 / $1,288.25	Facility		$263.03	$776.25	$1,288.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $263.03 / $537.03	Professional		$194.98	$263.03	$537.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility		$2,041.74	$2,041.74	$2,041.74
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $1,548.82 / $1,905.46	Professional		$338.84	$1,548.82	$1,905.46
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $331.13 / $1,122.02	Facility		$141.25	$331.13	$1,122.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $346.74 / $851.14	Professional		$169.82	$346.74	$851.14
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 $151.36 / $549.54 / $575.44	Facility		$151.36	$549.54	$575.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $478.63 / $870.96	Professional		$380.19	$478.63	$870.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $295.12 / $1,000.00	Facility		$125.89	$295.12	$1,000.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $512.86	Professional		$194.98	$257.04	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $870.96 / $1,148.15	Facility		$208.93	$870.96	$1,148.15
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $426.58	Professional		$208.93	$269.15	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $436.52	Professional		$416.87	$416.87	$436.52