Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.75 / $121.30 / $158.62	Facility		$42.75	$121.30	$158.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $70.84 / $107.45	Professional		$37.36	$70.84	$107.45
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $68.34 / $93.51 / $116.39	Professional	25	$68.34	$93.51	$116.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.53 / $82.32 / $122.96	Professional		$79.53	$82.32	$122.96
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $82.32 / $87.26 / $105.40	Professional	25	$82.32	$87.26	$105.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.04 / $354.75 / $427.78	Facility		$73.04	$354.75	$427.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.89 / $67.75 / $110.38	Professional		$39.89	$67.75	$110.38
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $51.56 / $85.52 / $127.60	Professional		$51.56	$85.52	$127.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $41.03 / $91.18 / $108.71	Facility		$41.03	$91.18	$108.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.40 / $77.67 / $130.81	Professional		$46.40	$77.67	$130.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $224.03 / $247.71 / $247.71	Facility		$224.03	$247.71	$247.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $325.91 / $563.47 / $727.80	Professional		$325.91	$563.47	$727.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $40.34 / $68.25 / $107.02	Facility		$40.34	$68.25	$107.02
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.15 / $93.85 / $136.62	Professional		$56.15	$93.85	$136.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.49 / $85.94 / $164.13	Professional		$44.49	$85.94	$164.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.84 / $67.76 / $107.02	Facility		$39.84	$67.76	$107.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.87 / $82.32 / $140.30	Professional		$46.87	$82.32	$140.30
United Facility/Professional Professional Modifier Low / Median / High Price $60.77 / $77.33 / $111.60	Professional		$60.77	$77.33	$111.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $71.37 / $86.37	Professional		$55.00	$71.37	$86.37