Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.75 / $83.08 / $270.39	Facility		$57.75	$83.08	$270.39
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $74.98 / $270.57 / $600.32	Facility	25	$74.98	$270.57	$600.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.06 / $78.73 / $173.60	Professional		$52.06	$78.73	$173.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $49.98 / $92.83 / $214.07	Professional	25	$49.98	$92.83	$214.07
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $76.70 / $106.29	Professional		$51.00	$76.70	$106.29
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $50.00 / $86.34 / $112.24	Professional	25	$50.00	$86.34	$112.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.80 / $78.06 / $78.06	Facility		$62.80	$78.06	$78.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.03 / $55.95 / $78.06	Professional		$42.03	$55.95	$78.06
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $65.73 / $101.02 / $150.00	Facility		$65.73	$101.02	$150.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $63.92 / $92.06 / $142.00	Professional		$63.92	$92.06	$142.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $56.88 / $62.72 / $85.75	Facility		$56.88	$62.72	$85.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $155.00 / $235.00	Facility		$110.00	$155.00	$235.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $79.67 / $129.34	Professional		$53.87	$79.67	$129.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $84.38 / $323.29 / $323.29	Facility		$84.38	$323.29	$323.29
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $186.38 / $202.06 / $202.06	Facility	62	$186.38	$202.06	$202.06
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $29.82 / $32.33 / $32.33	Facility	AS	$29.82	$32.33	$32.33
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $103.63 / $567.54 / $567.54	Professional		$103.63	$567.54	$567.54
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.57 / $73.38 / $122.36	Facility		$47.57	$73.38	$122.36
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $95.07 / $146.77	Professional		$62.99	$95.07	$146.77
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $88.77 / $88.77 / $88.77	Professional	50	$88.77	$88.77	$88.77
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $76.93 / $99.65 / $553.65	Facility		$76.93	$99.65	$553.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.85 / $90.68 / $155.56	Professional		$58.85	$90.68	$155.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.98 / $73.69 / $124.81	Facility		$47.98	$73.69	$124.81
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $84.21 / $164.22	Professional		$53.87	$84.21	$164.22
Providence Facility/Professional Professional Modifier 25 Low / Median / High Price $41.00 / $41.00 / $41.00	Professional	25	$41.00	$41.00	$41.00
United Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $76.93 / $114.23	Professional		$56.97	$76.93	$114.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.92 / $89.01 / $120.88	Professional		$75.92	$89.01	$120.88