Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $269.15	Professional		$38.02	$61.66	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $29.51 / $79.43	Professional		$28.84	$29.51	$79.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $151.36	Professional		$79.43	$79.43	$151.36
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $79.43 / $131.83	Professional		$52.48	$79.43	$131.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $57.54 / $57.54	Facility		$48.98	$57.54	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $131.83	Professional		$29.51	$45.71	$131.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $1,000.00	Professional		$489.78	$489.78	$1,000.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $85.11 / $151.36	Facility		$48.98	$85.11	$151.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $72.44 / $177.83	Professional		$37.15	$72.44	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $57.54	Professional		$32.36	$33.11	$57.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.33 / $128.82	Professional		$57.54	$102.33	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $79.43 / $144.54	Facility		$46.77	$79.43	$144.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $141.25	Professional		$29.51	$45.71	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $144.54	Professional		$39.81	$52.48	$144.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $58.88	Professional		$25.70	$25.70	$58.88