Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.12 / $70.52 / $224.02	Facility		$16.12	$70.52	$224.02
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $41.54 / $76.77 / $100.81	Facility	CQ	$41.54	$76.77	$100.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.04 / $19.85 / $32.20	Professional		$14.04	$19.85	$32.20
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $21.66 / $21.66 / $21.66	Professional	CQ	$21.66	$21.66	$21.66
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $31.50 / $31.50 / $31.50	Professional	CQ	$31.50	$31.50	$31.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.99 / $75.93 / $150.91	Facility		$30.99	$75.93	$150.91
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 $29.44 / $62.39 / $75.02	Facility		$29.44	$62.39	$75.02
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $27.65 / $33.36 / $48.23	Professional		$27.65	$33.36	$48.23
Christus Facility/Professional Facility Modifier Low / Median / High Price $28.47 / $29.20 / $29.20	Facility		$28.47	$29.20	$29.20
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 $18.20 / $32.04 / $94.72	Professional		$18.20	$32.04	$94.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $134.74 / $152.00	Facility		$80.00	$134.74	$152.00
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 $186.26 / $186.26 / $241.95	Professional		$186.26	$186.26	$241.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $19.09 / $29.01 / $54.91	Facility		$19.09	$29.01	$54.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $35.99 / $51.19	Professional		$22.50	$35.99	$51.19
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $159.00 / $211.00	Facility		$75.00	$159.00	$211.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $29.85 / $58.02	Professional		$22.39	$29.85	$58.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $18.98 / $29.01 / $55.00	Facility		$18.98	$29.01	$55.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $37.21 / $99.29	Professional		$19.05	$37.21	$99.29
United Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $26.32 / $31.04	Professional		$21.94	$26.32	$31.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.57 / $28.00 / $80.00	Professional		$24.57	$28.00	$80.00