Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.60 / $152.85 / $361.35	Facility		$114.60	$152.85	$361.35
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $188.10 / $412.43 / $889.61	Facility	25	$188.10	$412.43	$889.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $163.36 / $370.00	Professional		$106.97	$163.36	$370.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.95 / $194.42 / $539.00	Professional	25	$115.95	$194.42	$539.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.73 / $158.91 / $206.58	Professional		$124.73	$158.91	$206.58
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $127.54 / $160.24 / $199.16	Professional	25	$127.54	$160.24	$199.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.18 / $182.58 / $481.43	Facility		$131.18	$182.58	$481.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.47 / $132.24 / $170.18	Professional		$105.47	$132.24	$170.18
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $133.53 / $179.71 / $271.33	Professional		$133.53	$179.71	$271.33
Christus Facility/Professional Facility Modifier Low / Median / High Price $115.57 / $134.53 / $157.72	Facility		$115.57	$134.53	$157.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $160.00 / $235.00	Facility		$125.00	$160.00	$235.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $173.58 / $274.20	Professional		$126.00	$173.58	$274.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $559.77 / $652.65 / $652.65	Facility		$559.77	$652.65	$652.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $222.47 / $1,041.60 / $1,041.60	Professional		$222.47	$1,041.60	$1,041.60
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.79 / $163.82 / $268.39	Facility		$108.79	$163.82	$268.39
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.99 / $197.46 / $291.58	Professional		$144.99	$197.46	$291.58
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $118.85 / $287.60 / $516.62	Facility		$118.85	$287.60	$516.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.46 / $171.60 / $285.95	Professional		$120.46	$171.60	$285.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.79 / $164.45 / $272.49	Facility		$108.79	$164.45	$272.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.57 / $179.56 / $343.66	Professional		$123.57	$179.56	$343.66
United Facility/Professional Facility Modifier Low / Median / High Price $188.95 / $188.95 / $189.60	Facility		$188.95	$188.95	$189.60
United Facility/Professional Professional Modifier Low / Median / High Price $125.55 / $168.69 / $253.98	Professional		$125.55	$168.69	$253.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.41 / $163.37 / $222.47	Professional		$139.41	$163.37	$222.47