Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $70.79 / $316.23	Facility		$28.84	$70.79	$316.23
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $50.12 / $162.18 / $323.59	Facility	25	$50.12	$162.18	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $50.12 / $109.65	Professional		$28.84	$50.12	$109.65
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $57.54 / $123.03	Professional	25	$32.36	$57.54	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $52.48 / $70.79	Professional		$30.20	$52.48	$70.79
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $53.70 / $70.79	Professional	25	$37.15	$53.70	$70.79
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	50	$54.95	$54.95	$54.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $27.54 / $46.77	Facility		$26.30	$27.54	$46.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $33.11 / $50.12	Professional		$21.38	$33.11	$50.12
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $56.23 / $87.10	Facility		$35.48	$56.23	$87.10
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $91.20	Professional		$33.88	$57.54	$91.20
Christus Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $43.65 / $57.54	Facility		$30.90	$43.65	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $158.49 / $234.42	Facility		$67.61	$158.49	$234.42
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	22	$64.57	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	62	$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.37 / $5.37 / $5.37	Facility	AS	$5.37	$5.37	$5.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $83.18	Professional		$28.84	$46.77	$83.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $223.87 / $223.87	Facility		$44.67	$223.87	$223.87
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	62	$141.25	$141.25	$141.25
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $22.39 / $22.39 / $22.39	Facility	AS	$22.39	$22.39	$22.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $354.81	Professional		$40.74	$66.07	$354.81
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $47.86 / $85.11	Facility		$28.18	$47.86	$85.11
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $50.12 / $177.83 / $323.59	Facility	25	$50.12	$177.83	$323.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $43.65 / $83.18	Professional		$28.18	$43.65	$83.18
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $30.20 / $57.54 / $125.89	Professional	25	$30.20	$57.54	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $25.70 / $33.11	Professional		$13.49	$25.70	$33.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $79.43 / $186.21	Facility		$70.79	$79.43	$186.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $72.44 / $213.80	Professional		$33.88	$72.44	$213.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $47.86 / $85.11	Facility		$28.18	$47.86	$85.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $89.13	Professional		$28.84	$46.77	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $47.86 / $48.98	Facility		$30.90	$47.86	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.02 / $61.66	Professional		$22.91	$38.02	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $57.54 / $64.57	Professional		$19.05	$57.54	$64.57