Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.26 / $154.44 / $370.35	Facility		$119.26	$154.44	$370.35
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $128.01 / $388.75 / $736.80	Facility	25	$128.01	$388.75	$736.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.94 / $148.69 / $356.10	Professional		$101.94	$148.69	$356.10
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $108.31 / $212.26 / $498.16	Professional	25	$108.31	$212.26	$498.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.04 / $170.89 / $210.98	Professional		$136.04	$170.89	$210.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $137.13 / $170.89 / $222.15	Professional	25	$137.13	$170.89	$222.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.44 / $131.97 / $394.80	Facility		$118.44	$131.97	$394.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.36 / $116.91 / $154.72	Professional		$91.36	$116.91	$154.72
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $142.97 / $373.06	Facility		$64.40	$142.97	$373.06
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $139.22 / $189.12 / $272.08	Professional		$139.22	$189.12	$272.08
Christus Facility/Professional Facility Modifier Low / Median / High Price $124.25 / $150.02 / $169.62	Facility		$124.25	$150.02	$169.62
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 $117.44 / $164.10 / $263.17	Professional		$117.44	$164.10	$263.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $174.71 / $649.44 / $705.38	Facility		$174.71	$649.44	$705.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $225.32 / $1,127.38 / $1,127.38	Professional		$225.32	$1,127.38	$1,127.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.97 / $150.97 / $244.32	Facility		$108.97	$150.97	$244.32
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.91 / $206.03 / $298.58	Professional		$144.91	$206.03	$298.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $128.80 / $184.46 / $307.86	Professional		$128.80	$184.46	$307.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.84 / $151.83 / $244.78	Facility		$109.84	$151.83	$244.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $113.84 / $171.61 / $339.84	Professional		$113.84	$171.61	$339.84
United Facility/Professional Professional Modifier Low / Median / High Price $111.65 / $153.97 / $230.24	Professional		$111.65	$153.97	$230.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $149.90 / $175.82 / $239.25	Professional		$149.90	$175.82	$239.25