Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.69 / $89.27 / $470.63	Facility		$18.69	$89.27	$470.63
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $40.07 / $49.08 / $145.30	Facility	CO	$40.07	$49.08	$145.30
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $40.85 / $84.13 / $493.73	Facility	CQ	$40.85	$84.13	$493.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.03 / $22.29 / $71.31	Professional		$14.03	$22.29	$71.31
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $21.22 / $42.64 / $82.14	Professional	CQ	$21.22	$42.64	$82.14
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $35.01 / $50.03 / $50.03	Professional	CQ	$35.01	$50.03	$50.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.35 / $77.43 / $152.99	Facility		$31.35	$77.43	$152.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.87 / $23.56 / $23.56	Professional		$20.87	$23.56	$23.56
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $85.34 / $120.00	Facility		$29.01	$85.34	$120.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $33.60 / $63.00	Professional		$28.56	$33.60	$63.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $28.47 / $48.89 / $48.89	Facility		$28.47	$48.89	$48.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $65.00 / $75.00	Facility		$55.00	$65.00	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.77 / $35.19 / $102.55	Professional		$19.77	$35.19	$102.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $79.48 / $134.74 / $152.00	Facility		$79.48	$134.74	$152.00
Lucent Health Facility/Professional Facility Modifier CO Low / Median / High Price $42.50 / $114.53 / $129.19	Facility	CO	$42.50	$114.53	$129.19
Lucent Health Facility/Professional Facility Modifier CQ Low / Median / High Price $42.50 / $114.53 / $129.19	Facility	CQ	$42.50	$114.53	$129.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $31.04 / $186.26 / $241.95	Professional		$31.04	$186.26	$241.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.55 / $31.57 / $86.03	Facility		$19.55	$31.57	$86.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $28.84 / $47.81	Professional		$22.71	$28.84	$47.81
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $19.61 / $21.72 / $31.54	Professional	CQ	$19.61	$21.72	$31.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.05 / $29.85 / $58.02	Professional		$22.05	$29.85	$58.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $65.00 / $75.00	Facility		$55.00	$65.00	$75.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $38.86 / $105.33	Professional		$20.42	$38.86	$105.33
United Facility/Professional Professional Modifier Low / Median / High Price $23.49 / $26.69 / $34.97	Professional		$23.49	$26.69	$34.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.57 / $28.00 / $80.00	Professional		$24.57	$28.00	$80.00