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 / $83.18 / $295.12	Professional		$52.48	$83.18	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $46.77 / $93.33	Professional		$30.90	$46.77	$93.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $112.20 / $131.83	Professional		$44.67	$112.20	$131.83
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $144.54	Professional		$85.11	$128.82	$144.54
Christus Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $91.20 / $93.33	Facility		$67.61	$91.20	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $58.88 / $162.18	Professional		$40.74	$58.88	$162.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $512.86	Facility		$512.86	$512.86	$512.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $794.33 / $794.33	Professional		$602.56	$794.33	$794.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $100.00 / $165.96	Facility		$61.66	$100.00	$165.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $95.50 / $213.80	Professional		$52.48	$95.50	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $125.89 / $208.93	Professional		$69.18	$125.89	$208.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $100.00 / $169.82	Facility		$60.26	$100.00	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $173.78	Professional		$39.81	$53.70	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Facility		$83.18	$83.18	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $61.66 / $199.53	Professional		$51.29	$61.66	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $95.50	Professional		$34.67	$34.67	$95.50