Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $39.81 / $186.21	Facility		$8.91	$39.81	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $12.88 / $26.92	Professional		$8.91	$12.88	$26.92
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $19.05 / $19.05 / $19.05	Professional	CO	$19.05	$19.05	$19.05
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $11.48 / $29.51 / $60.26	Professional	CQ	$11.48	$29.51	$60.26
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $10.96 / $11.48 / $13.49	Professional	CQ	$10.96	$11.48	$13.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $38.90 / $74.13	Facility		$16.60	$38.90	$74.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $12.02 / $12.02	Professional		$10.72	$12.02	$12.02
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $51.29 / $120.23	Facility		$16.60	$51.29	$120.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $17.38 / $50.12	Professional		$12.88	$17.38	$50.12
Christus Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $15.49 / $15.49	Facility		$14.45	$15.49	$15.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $64.57 / $75.86	Facility		$54.95	$64.57	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $13.80 / $27.54	Professional		$10.00	$13.80	$27.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $100.00 / $100.00	Facility		$91.20	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $30.20 / $120.23	Professional		$14.45	$30.20	$120.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $16.22 / $33.11	Facility		$9.55	$16.22	$33.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $12.88 / $26.30	Professional		$7.94	$12.88	$26.30
Moda Health Facility/Professional Professional Modifier CO Low / Median / High Price $19.05 / $19.05 / $19.05	Professional	CO	$19.05	$19.05	$19.05
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $12.88 / $37.15 / $75.86	Professional	CQ	$12.88	$37.15	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.11 / $37.15	Professional		$29.51	$33.11	$37.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $16.60 / $53.70	Professional		$13.49	$16.60	$53.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $9.55 / $16.60 / $31.62	Facility		$9.55	$16.60	$31.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $13.49 / $27.54	Professional		$10.00	$13.49	$27.54
United Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $11.75 / $16.22	Facility		$11.75	$11.75	$16.22
United Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $14.13 / $20.42	Professional		$11.75	$14.13	$20.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Professional		$14.79	$14.79	$14.79