Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.52 / $230.79 / $632.71	Facility		$91.52	$230.79	$632.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $92.76 / $208.35	Professional		$74.20	$92.76	$208.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $74.20 / $74.20	Professional		$74.20	$74.20	$74.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.00 / $394.54 / $681.48	Facility		$152.00	$394.54	$681.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $68.02 / $173.15	Professional		$5.00	$68.02	$173.15
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $123.68 / $185.52 / $698.54	Facility		$123.68	$185.52	$698.54
Christus Facility/Professional Facility Modifier Low / Median / High Price $123.68 / $207.78 / $207.78	Facility		$123.68	$207.78	$207.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.79 / $287.61 / $625.38	Facility		$111.79	$287.61	$625.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $117.50 / $245.00	Professional		$63.56	$117.50	$245.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $303.02 / $587.48 / $587.48	Facility		$303.02	$587.48	$587.48
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $618.40 / $618.40 / $927.60	Professional		$618.40	$618.40	$927.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.92 / $123.68 / $210.64	Facility		$77.92	$123.68	$210.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $117.50 / $123.68 / $154.60	Professional		$117.50	$123.68	$154.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $80.39 / $148.41 / $278.27	Professional		$80.39	$148.41	$278.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.76 / $152.09 / $533.95	Facility		$92.76	$152.09	$533.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $142.22 / $224.61	Professional		$65.95	$142.22	$224.61
United Facility/Professional Facility Modifier Low / Median / High Price $44.52 / $51.95 / $123.68	Facility		$44.52	$51.95	$123.68
United Facility/Professional Professional Modifier Low / Median / High Price $51.95 / $70.87 / $101.24	Professional		$51.95	$70.87	$101.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.24 / $123.68 / $166.97	Professional		$48.24	$123.68	$166.97