Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.54 / $66.79 / $227.93	Facility		$44.54	$66.79	$227.93
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $115.83 / $219.83 / $275.92	Facility	25	$115.83	$219.83	$275.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.11 / $66.18 / $124.71	Professional		$39.11	$66.18	$124.71
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $46.40 / $86.32 / $203.00	Professional	25	$46.40	$86.32	$203.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.42 / $67.66 / $87.95	Professional		$44.42	$67.66	$87.95
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $50.00 / $57.51 / $74.43	Professional	25	$50.00	$57.51	$74.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.64 / $71.64 / $75.77	Facility		$71.64	$71.64	$75.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.01 / $53.49 / $73.06	Professional		$38.01	$53.49	$73.06
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $78.80 / $78.80 / $108.26	Facility		$78.80	$78.80	$108.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $74.79 / $110.00	Professional		$49.69	$74.79	$110.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $40.67 / $42.80 / $67.23	Facility		$40.67	$42.80	$67.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $155.00 / $235.00	Facility		$120.00	$155.00	$235.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.67 / $72.76 / $119.92	Professional		$46.67	$72.76	$119.92
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $211.96 / $229.71 / $229.71	Facility		$211.96	$229.71	$229.71
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $302.33 / $456.37 / $456.37	Professional		$302.33	$456.37	$456.37
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $41.70 / $69.81 / $109.26	Facility		$41.70	$69.81	$109.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $84.24 / $125.77	Professional		$58.88	$84.24	$125.77
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $54.36 / $103.59 / $379.00	Facility		$54.36	$103.59	$379.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $71.23 / $122.33	Professional		$42.16	$71.23	$122.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.70 / $70.05 / $111.84	Facility		$41.70	$70.05	$111.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $76.70 / $139.40	Professional		$49.00	$76.70	$139.40
United Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $77.23 / $116.25	Professional		$57.92	$77.23	$116.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.63 / $69.90 / $94.74	Professional		$59.63	$69.90	$94.74