Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.84 / $202.13 / $457.20	Facility		$151.84	$202.13	$457.20
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $246.26 / $330.75 / $512.11	Facility	25	$246.26	$330.75	$512.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.51 / $194.79 / $504.49	Professional		$142.51	$194.79	$504.49
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $147.32 / $256.64 / $725.00	Professional	25	$147.32	$256.64	$725.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.09 / $209.99 / $262.82	Professional		$172.09	$209.99	$262.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $178.49 / $209.99 / $266.52	Professional	25	$178.49	$209.99	$266.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.30 / $174.30 / $513.57	Facility		$174.30	$174.30	$513.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $178.69 / $222.92	Professional		$143.22	$178.69	$222.92
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $192.42 / $192.42 / $192.42	Facility		$192.42	$192.42	$192.42
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $178.09 / $237.31 / $321.95	Professional		$178.09	$237.31	$321.95
Christus Facility/Professional Facility Modifier Low / Median / High Price $158.34 / $184.94 / $208.41	Facility		$158.34	$184.94	$208.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $160.00 / $242.44	Facility		$125.00	$160.00	$242.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.69 / $223.74 / $345.30	Professional		$163.69	$223.74	$345.30
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $232.32 / $822.00 / $888.06	Facility		$232.32	$822.00	$888.06
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $323.45 / $1,377.15 / $1,377.15	Professional		$323.45	$1,377.15	$1,377.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $146.69 / $211.97 / $345.57	Facility		$146.69	$211.97	$345.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $199.21 / $268.73 / $385.11	Professional		$199.21	$268.73	$385.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $165.20 / $228.77 / $377.55	Professional		$165.20	$228.77	$377.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $146.28 / $212.03 / $345.57	Facility		$146.28	$212.03	$345.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $160.59 / $232.78 / $454.48	Professional		$160.59	$232.78	$454.48
United Facility/Professional Professional Modifier Low / Median / High Price $158.34 / $214.16 / $323.38	Professional		$158.34	$214.16	$323.38
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $88.00	Professional	25	$80.00	$80.00	$88.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $184.14 / $215.74 / $293.99	Professional		$184.14	$215.74	$293.99