Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.20 / $240.02 / $672.67	Facility		$82.20	$240.02	$672.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.31 / $102.75 / $329.01	Professional		$39.31	$102.75	$329.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.25 / $34.25 / $82.20	Professional		$34.25	$34.25	$82.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.88 / $338.39 / $708.29	Facility		$169.88	$338.39	$708.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $75.34 / $191.80	Professional		$5.00	$75.34	$191.80
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $123.30 / $191.80	Professional		$95.90	$123.30	$191.80
Christus Facility/Professional Facility Modifier Low / Median / High Price $137.00 / $137.00 / $137.00	Facility		$137.00	$137.00	$137.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.27 / $300.99 / $609.98	Facility		$91.27	$300.99	$609.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.34 / $76.61 / $213.75	Professional		$62.34	$76.61	$213.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $266.68 / $650.75 / $650.75	Facility		$266.68	$650.75	$650.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $685.00 / $685.00 / $1,027.50	Professional		$685.00	$685.00	$1,027.50
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $83.57 / $137.00 / $205.50	Facility		$83.57	$137.00	$205.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $137.00 / $137.00 / $171.25	Professional		$137.00	$137.00	$171.25
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $136.44 / $186.72 / $284.01	Facility		$136.44	$186.72	$284.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.05 / $164.40 / $308.25	Professional		$89.05	$164.40	$308.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.06 / $146.93 / $493.55	Facility		$93.06	$146.93	$493.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.01 / $123.30 / $207.89	Professional		$63.01	$123.30	$207.89
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $84.39	Professional		$57.54	$57.54	$84.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.43 / $137.00 / $184.95	Professional		$53.43	$137.00	$184.95