Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.52 / $129.60 / $312.91	Facility		$64.52	$129.60	$312.91
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $189.31 / $209.00 / $607.84	Facility	25	$189.31	$209.00	$607.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.83 / $105.00 / $156.53	Professional		$50.83	$105.00	$156.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $27.49 / $128.75 / $200.00	Professional	25	$27.49	$128.75	$200.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.72 / $122.37 / $175.25	Professional		$112.72	$122.37	$175.25
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $115.56 / $123.84 / $173.96	Professional	25	$115.56	$123.84	$173.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.84 / $244.61 / $427.78	Facility		$56.84	$244.61	$427.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $100.39 / $161.30	Professional		$59.96	$100.39	$161.30
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $72.65 / $120.97 / $181.09	Professional		$72.65	$120.97	$181.09
Christus Facility/Professional Facility Modifier Low / Median / High Price $61.62 / $108.71 / $123.74	Facility		$61.62	$108.71	$123.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.51 / $114.95 / $191.55	Professional		$67.51	$114.95	$191.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $337.57 / $372.83 / $372.83	Facility		$337.57	$372.83	$372.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $140.72 / $797.90 / $1,027.88	Professional		$140.72	$797.90	$1,027.88
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.42 / $98.83 / $153.75	Facility		$60.42	$98.83	$153.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $84.61 / $133.08 / $203.54	Professional		$84.61	$133.08	$203.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $123.12 / $230.89	Professional		$66.23	$123.12	$230.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.08 / $98.09 / $153.50	Facility		$60.08	$98.09	$153.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $71.25 / $119.44 / $203.71	Professional		$71.25	$119.44	$203.71
United Facility/Professional Professional Modifier Low / Median / High Price $90.78 / $112.14 / $160.15	Professional		$90.78	$112.14	$160.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $80.00 / $122.37	Professional		$55.00	$80.00	$122.37