Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $154.88 / $162.18	Facility		$141.25	$154.88	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $144.54	Professional		$38.02	$72.44	$144.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $75.86 / $97.72 / $154.88	Professional	25	$75.86	$97.72	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $81.28 / $97.72	Professional		$75.86	$81.28	$97.72
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $72.44 / $75.86 / $117.49	Professional	25	$72.44	$75.86	$117.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $354.81 / $426.58	Facility		$72.44	$354.81	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $67.61 / $102.33	Professional		$36.31	$67.61	$102.33
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $87.10 / $128.82	Professional		$46.77	$87.10	$128.82
Christus Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $56.23 / $83.18	Facility		$37.15	$56.23	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $74.13 / $128.82	Professional		$42.66	$74.13	$128.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $288.40 / $288.40	Facility		$288.40	$288.40	$288.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $549.54 / $691.83	Professional		$89.13	$549.54	$691.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $69.18 / $109.65	Facility		$38.02	$69.18	$109.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $64.57 / $125.89	Professional		$36.31	$64.57	$125.89
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $70.79 / $93.33 / $169.82	Professional	25	$70.79	$93.33	$169.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $36.31 / $70.79	Professional		$32.36	$36.31	$70.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $81.28 / $165.96	Professional		$38.02	$81.28	$165.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $67.61 / $109.65	Facility		$38.90	$67.61	$109.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $77.62 / $128.82	Professional		$43.65	$77.62	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $93.33	Professional		$38.02	$60.26	$93.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $85.11	Professional		$50.12	$70.79	$85.11