Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $81.28 / $309.03	Professional		$52.48	$81.28	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $109.65	Professional		$38.90	$77.62	$109.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $107.15 / $199.53	Professional		$43.65	$107.15	$199.53
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $141.25	Professional		$72.44	$97.72	$141.25
Christus Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $81.28	Facility		$77.62	$77.62	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $169.82	Professional		$40.74	$57.54	$169.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $524.81 / $524.81	Facility		$524.81	$524.81	$524.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $660.69 / $1,202.26	Professional		$660.69	$660.69	$1,202.26
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $104.71 / $147.91	Facility		$61.66	$104.71	$147.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $91.20 / $223.87	Professional		$50.12	$91.20	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $75.86	Professional		$32.36	$33.11	$75.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $138.04 / $173.78	Professional		$79.43	$138.04	$173.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $104.71 / $181.97	Facility		$63.10	$104.71	$181.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $177.83	Professional		$40.74	$57.54	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $69.18 / $190.55	Professional		$53.70	$69.18	$190.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $79.43	Professional		$34.67	$34.67	$79.43