Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $575.44	Facility		$100.00	$100.00	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $125.89	Professional		$83.18	$85.11	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $72.44 / $83.18	Professional		$63.10	$72.44	$83.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $275.42 / $512.86	Facility		$109.65	$275.42	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $363.08	Facility		$89.13	$89.13	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $229.09	Facility		$100.00	$100.00	$229.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $131.83	Professional		$83.18	$100.00	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $114.82 / $302.00	Facility		$91.20	$114.82	$302.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $100.00 / $131.83	Professional		$81.28	$100.00	$131.83