Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $302.00 / $602.56	Professional		$223.87	$302.00	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $281.84 / $389.05	Professional		$234.42	$281.84	$389.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $467.74	Professional		$239.88	$281.84	$467.74
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $389.05 / $794.33	Professional		$288.40	$389.05	$794.33
Christus Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $302.00	Facility		$288.40	$288.40	$302.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $478.63 / $478.63	Facility		$478.63	$478.63	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $316.23 / $524.81	Professional		$239.88	$316.23	$524.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility		$1,862.09	$1,862.09	$1,862.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $2,398.83 / $2,398.83	Professional		$1,905.46	$2,398.83	$2,398.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $346.74 / $562.34	Facility		$269.15	$346.74	$562.34
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $562.34	Professional		$223.87	$309.03	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $457.09 / $724.44	Professional		$309.03	$457.09	$724.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $346.74 / $549.54	Facility		$263.03	$346.74	$549.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $323.59 / $645.65	Professional		$234.42	$323.59	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $407.38	Professional		$194.98	$257.04	$407.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $302.00 / $380.19	Professional		$186.21	$302.00	$380.19