Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $162.00 / $341.65	Facility		$75.00	$162.00	$341.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.26 / $156.99 / $214.44	Professional		$124.26	$156.99	$214.44
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $172.37 / $172.37 / $172.37	Professional	25	$172.37	$172.37	$172.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.29 / $161.25 / $197.00	Professional		$123.29	$161.25	$197.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.50 / $155.50 / $238.38	Professional		$120.50	$155.50	$238.38
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $141.83 / $189.38 / $313.00	Professional		$141.83	$189.38	$313.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $158.81 / $166.30 / $199.59	Facility		$158.81	$166.30	$199.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $173.50 / $265.79	Professional		$84.00	$173.50	$265.79
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $765.98 / $818.71 / $818.71	Facility		$765.98	$818.71	$818.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,080.07 / $1,234.10 / $1,560.60	Professional		$1,080.07	$1,234.10	$1,560.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $153.90 / $180.00 / $221.93	Facility		$153.90	$180.00	$221.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $172.37 / $216.12 / $338.27	Professional		$172.37	$216.12	$338.27
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $458.00 / $458.00 / $458.00	Facility		$458.00	$458.00	$458.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.78 / $206.76 / $284.56	Professional		$154.78	$206.76	$284.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.50 / $180.00 / $221.93	Facility		$151.50	$180.00	$221.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $168.00 / $277.89	Professional		$96.00	$168.00	$277.89
United Facility/Professional Professional Modifier Low / Median / High Price $119.63 / $162.15 / $258.52	Professional		$119.63	$162.15	$258.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.38 / $188.81 / $258.92	Professional		$160.38	$188.81	$258.92