Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.70 / $72.84 / $344.00	Facility		$20.70	$72.84	$344.00
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $165.00 / $165.00 / $165.00	Facility	CO	$165.00	$165.00	$165.00
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $33.06 / $50.55 / $136.62	Facility	CQ	$33.06	$50.55	$136.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $23.00 / $41.76	Professional		$15.66	$23.00	$41.76
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $62.04 / $62.04 / $62.04	Professional	CQ	$62.04	$62.04	$62.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.96 / $86.35 / $172.70	Facility		$34.96	$86.35	$172.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.25 / $26.23 / $26.23	Professional		$23.25	$26.23	$26.23
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $35.72 / $80.25 / $119.08	Facility		$35.72	$80.25	$119.08
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $25.91 / $35.49 / $51.62	Professional		$25.91	$35.49	$51.62
Christus Facility/Professional Facility Modifier Low / Median / High Price $31.65 / $36.86 / $36.86	Facility		$31.65	$36.86	$36.86
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 $21.91 / $38.86 / $103.15	Professional		$21.91	$38.86	$103.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $149.85 / $170.34	Facility		$80.00	$149.85	$170.34
Lucent Health Facility/Professional Facility Modifier CO Low / Median / High Price $43.41 / $127.37 / $144.79	Facility	CO	$43.41	$127.37	$144.79
Lucent Health Facility/Professional Facility Modifier CQ Low / Median / High Price $43.41 / $127.37 / $144.79	Facility	CQ	$43.41	$127.37	$144.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $207.96 / $270.23	Professional		$36.06	$207.96	$270.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $21.13 / $33.13 / $52.52	Facility		$21.13	$33.13	$52.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $39.61 / $57.64	Professional		$25.04	$39.61	$57.64
Moda Health Facility/Professional Professional Modifier CQ Low / Median / High Price $26.22 / $31.30 / $31.30	Professional	CQ	$26.22	$31.30	$31.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.42 / $32.78 / $64.23	Professional		$27.42	$32.78	$64.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.13 / $33.43 / $57.39	Facility		$21.13	$33.43	$57.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.33 / $42.83 / $105.33	Professional		$22.33	$42.83	$105.33
United Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $29.76 / $36.10	Professional		$26.26	$29.76	$36.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.33 / $31.06 / $80.00	Professional		$27.33	$31.06	$80.00