Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $151.36 / $436.52	Facility		$75.86	$151.36	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $281.84	Professional		$100.00	$134.90	$281.84
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $123.03 / $446.68 / $446.68	Professional	25	$123.03	$446.68	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $165.96	Professional		$93.33	$123.03	$165.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $128.82 / $190.55	Professional		$104.71	$128.82	$190.55
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $158.49 / $229.09	Professional		$100.00	$158.49	$229.09
Christus Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $128.82 / $151.36	Facility		$114.82	$128.82	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $199.53	Professional		$75.86	$125.89	$199.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $194.98 / $1,258.93	Professional		$138.04	$194.98	$1,258.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $151.36 / $229.09	Facility		$125.89	$151.36	$229.09
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $229.09	Professional		$102.33	$131.83	$229.09
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	25	$446.68	$446.68	$446.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $102.33 / $128.82	Professional		$33.11	$102.33	$128.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $239.88	Professional		$104.71	$144.54	$239.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $154.88 / $229.09	Facility		$128.82	$154.88	$229.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $204.17	Professional		$77.62	$128.82	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $213.80	Professional		$102.33	$138.04	$213.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $204.17	Professional		$107.15	$169.82	$204.17