Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.74 / $126.30 / $230.13	Facility		$112.74	$126.30	$230.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $125.64 / $193.43	Professional		$72.00	$125.64	$193.43
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $159.37 / $341.58	Professional	25	$80.00	$159.37	$341.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $144.57 / $247.74	Professional		$133.29	$144.57	$247.74
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $138.33 / $144.04 / $165.65	Professional	25	$138.33	$144.04	$165.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.52 / $239.98 / $239.98	Facility		$127.52	$239.98	$239.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.15 / $118.86 / $186.57	Professional		$74.15	$118.86	$186.57
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $89.97 / $146.06 / $214.41	Professional		$89.97	$146.06	$214.41
Christus Facility/Professional Facility Modifier Low / Median / High Price $77.28 / $116.96 / $145.77	Facility		$77.28	$116.96	$145.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.50 / $138.33 / $233.55	Professional		$81.50	$138.33	$233.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $417.83 / $460.75 / $460.75	Facility		$417.83	$460.75	$460.75
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $172.91 / $944.28 / $1,210.43	Professional		$172.91	$944.28	$1,210.43
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $78.17 / $123.35 / $186.33	Facility		$78.17	$123.35	$186.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $167.70 / $247.36	Professional		$104.73	$167.70	$247.36
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $303.08 / $303.08 / $303.08	Professional	50	$303.08	$303.08	$303.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.21 / $146.66 / $271.73	Professional		$83.21	$146.66	$271.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.73 / $122.88 / $185.94	Facility		$77.73	$122.88	$185.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $90.45 / $144.10 / $243.52	Professional		$90.45	$144.10	$243.52
United Facility/Professional Professional Modifier Low / Median / High Price $104.64 / $134.69 / $190.21	Professional		$104.64	$134.69	$190.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $80.00 / $144.57	Professional		$55.00	$80.00	$144.57