Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $218.78 / $776.25	Facility		$85.11	$218.78	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $204.17	Professional		$85.11	$114.82	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $141.25	Professional		$60.26	$85.11	$141.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $436.52 / $741.31	Facility		$169.82	$436.52	$741.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $77.62 / $194.98	Professional		$5.01	$77.62	$194.98
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $158.49 / $229.09	Facility		$123.03	$158.49	$229.09
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $147.91 / $204.17	Professional		$100.00	$147.91	$204.17
Christus Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $141.25	Facility		$134.90	$134.90	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $138.04 / $630.96	Facility		$93.33	$138.04	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $245.47	Professional		$64.57	$95.50	$245.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $676.08 / $676.08	Facility		$676.08	$676.08	$676.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,071.52 / $1,071.52	Professional		$707.95	$1,071.52	$1,071.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $169.82 / $645.65	Facility		$102.33	$169.82	$645.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $199.53	Professional		$74.13	$114.82	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $144.54	Professional		$120.23	$120.23	$144.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $741.31 / $812.83	Facility		$354.81	$741.31	$812.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $302.00	Professional		$141.25	$154.88	$302.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $141.25 / $398.11	Facility		$100.00	$141.25	$398.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $104.71 / $223.87	Professional		$64.57	$104.71	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $60.26 / $141.25	Facility		$51.29	$60.26	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $97.72	Professional		$60.26	$60.26	$97.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $120.23 / $141.25	Professional		$56.23	$120.23	$141.25