Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $131.83 / $363.08	Facility		$23.44	$131.83	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $28.84 / $54.95	Professional		$17.78	$28.84	$54.95
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $72.44 / $87.10 / $204.17	Professional	CQ	$72.44	$87.10	$204.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $100.00 / $194.98	Facility		$42.66	$100.00	$194.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.90 / $30.90	Professional		$27.54	$30.90	$30.90
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $114.82 / $120.23	Facility		$41.69	$114.82	$120.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $60.26	Professional		$35.48	$42.66	$60.26
Christus Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $53.70 / $53.70	Facility		$36.31	$53.70	$53.70
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 $23.44 / $32.36 / $57.54	Professional		$23.44	$32.36	$57.54
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $158.49 / $309.03	Professional		$38.90	$158.49	$309.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $38.90 / $83.18	Facility		$23.44	$38.90	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $32.36 / $70.79	Professional		$17.78	$32.36	$70.79
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $72.44 / $204.17 / $338.84	Professional	CQ	$72.44	$204.17	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $33.11 / $38.90	Professional		$30.90	$33.11	$38.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $40.74 / $138.04	Professional		$33.11	$40.74	$138.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $38.02 / $64.57	Facility		$23.44	$38.02	$64.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $32.36 / $58.88	Professional		$24.55	$32.36	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $40.74	Facility		$29.51	$29.51	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $42.66	Professional		$29.51	$33.88	$42.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $37.15 / $37.15	Professional		$35.48	$37.15	$37.15