Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $115.61 / $136.02	Facility		$75.00	$115.61	$136.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.08 / $106.81 / $138.56	Professional		$84.08	$106.81	$138.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.93 / $102.83 / $120.98	Professional		$91.93	$102.83	$120.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.27 / $94.31 / $143.34	Professional		$72.27	$94.31	$143.34
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $84.69 / $120.85 / $187.52	Professional		$84.69	$120.85	$187.52
Christus Facility/Professional Facility Modifier Low / Median / High Price $106.91 / $575.00 / $575.00	Facility		$106.91	$575.00	$575.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $122.00 / $195.60	Professional		$81.59	$122.00	$195.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $511.66 / $546.01 / $546.01	Facility		$511.66	$546.01	$546.01
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $677.79 / $755.78 / $1,023.23	Professional		$677.79	$755.78	$1,023.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $105.70 / $129.07 / $160.50	Facility		$105.70	$129.07	$160.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $111.35 / $159.80 / $222.60	Professional		$111.35	$159.80	$222.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.15 / $142.82 / $201.50	Professional		$108.15	$142.82	$201.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.69 / $129.76 / $160.50	Facility		$104.69	$129.76	$160.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $116.00 / $198.32	Professional		$67.00	$116.00	$198.32
United Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $119.30 / $188.16	Professional		$88.93	$119.30	$188.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.91 / $123.42 / $169.37	Professional		$104.91	$123.42	$169.37