Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.80 / $414.80 / $479.40	Facility		$313.80	$414.80	$479.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $156.90 / $156.90 / $156.90	Facility	52	$156.90	$156.90	$156.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.35 / $35.25 / $62.39	Professional		$28.35	$35.25	$62.39
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $45.24 / $45.24 / $45.24	Professional	22	$45.24	$45.24	$45.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.32 / $17.39 / $23.56	Professional	52	$14.32	$17.39	$23.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $34.56 / $44.69	Professional		$31.74	$34.56	$44.69
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.30 / $10.30 / $10.75	Professional	52	$10.30	$10.30	$10.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.16 / $164.44 / $520.87	Facility		$87.16	$164.44	$520.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.30 / $26.09 / $29.45	Professional		$22.30	$26.09	$29.45
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $35.38 / $42.46 / $63.60	Professional		$35.38	$42.46	$63.60
Christus Facility/Professional Facility Modifier Low / Median / High Price $25.54 / $28.78 / $34.11	Facility		$25.54	$28.78	$34.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.85 / $42.81 / $46.90	Facility		$36.85	$42.81	$46.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.50 / $40.82 / $70.76	Professional		$29.50	$40.82	$70.76
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $143.82 / $158.69 / $158.69	Facility		$143.82	$158.69	$158.69
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $115.06 / $126.96 / $126.96	Facility	52	$115.06	$126.96	$126.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $202.03 / $279.23 / $296.02	Professional		$202.03	$279.23	$296.02
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $37.13 / $67.94	Facility		$28.18	$37.13	$67.94
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.42 / $40.54 / $57.16	Professional		$34.42	$40.54	$57.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $43.01 / $82.42	Professional		$28.59	$43.01	$82.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.36 / $37.86 / $66.81	Facility		$28.36	$37.86	$66.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.80 / $41.67 / $74.48	Professional		$29.80	$41.67	$74.48
United Facility/Professional Professional Modifier Low / Median / High Price $28.89 / $37.03 / $59.77	Professional		$28.89	$37.03	$59.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.09 / $34.38 / $48.13	Professional		$30.09	$34.38	$48.13