Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $104.71 / $190.55	Facility		$20.42	$104.71	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $25.12 / $33.88	Professional		$18.20	$25.12	$33.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $16.98 / $23.99	Professional		$13.49	$16.98	$23.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $89.13 / $165.96	Facility		$33.11	$89.13	$165.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $15.49 / $27.54	Professional		$5.01	$15.49	$27.54
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $43.65 / $169.82	Facility		$25.12	$43.65	$169.82
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $28.18 / $44.67	Professional		$19.50	$28.18	$44.67
Christus Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Facility		$28.18	$28.18	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $61.66 / $151.36	Facility		$27.54	$61.66	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.95 / $47.86	Professional		$14.79	$19.95	$47.86
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $138.04 / $138.04	Facility		$134.90	$138.04	$138.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $26.92 / $42.66	Professional		$23.99	$26.92	$42.66
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $28.18 / $177.83	Facility		$20.89	$28.18	$177.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $25.12 / $38.90	Professional		$15.85	$25.12	$38.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $23.44 / $23.44	Professional		$20.89	$23.44	$23.44
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $537.03 / $1,230.27	Facility		$380.19	$537.03	$1,230.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $28.18 / $83.18	Facility		$22.39	$28.18	$83.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $20.42 / $47.86	Professional		$15.85	$20.42	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $16.98 / $28.18	Facility		$10.00	$16.98	$28.18
United Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $16.60 / $23.99	Professional		$11.75	$16.60	$23.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $10.96 / $28.18	Professional		$10.96	$10.96	$28.18