Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $63.10 / $165.96	Facility		$23.99	$63.10	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $28.18 / $40.74	Professional		$20.89	$28.18	$40.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $20.42 / $28.84	Professional		$16.60	$20.42	$28.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $112.20 / $194.98	Facility		$44.67	$112.20	$194.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $18.62 / $33.88	Professional		$5.01	$18.62	$33.88
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $45.71 / $63.10	Facility		$31.62	$45.71	$63.10
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $54.95	Professional		$23.99	$33.88	$54.95
Christus Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Facility		$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $66.07 / $151.36	Facility		$31.62	$66.07	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.91 / $52.48	Professional		$18.20	$22.91	$52.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $32.36 / $56.23	Professional		$28.84	$32.36	$56.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $33.88 / $63.10	Facility		$25.70	$33.88	$63.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.84 / $40.74	Professional		$19.95	$28.84	$40.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $28.84 / $28.84	Professional		$25.70	$28.84	$28.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $33.88 / $100.00	Facility		$26.30	$33.88	$100.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $22.91 / $52.48	Professional		$17.78	$22.91	$52.48
United Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $20.42 / $33.88	Facility		$12.30	$20.42	$33.88
United Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $18.62 / $28.18	Professional		$14.45	$18.62	$28.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $33.88	Professional		$13.18	$13.18	$33.88