Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $588.84 / $1,000.00	Facility		$52.48	$588.84	$1,000.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $245.47 / $724.44 / $1,659.59	Facility	25	$245.47	$724.44	$1,659.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $91.20	Professional		$30.90	$51.29	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $43.65 / $120.23	Professional		$33.88	$43.65	$120.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $478.63 / $724.44	Facility		$141.25	$478.63	$724.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $37.15 / $48.98	Professional		$31.62	$37.15	$48.98
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $407.38 / $489.78	Facility		$46.77	$407.38	$489.78
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $154.88	Professional		$39.81	$53.70	$154.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $51.29 / $51.29	Facility		$39.81	$51.29	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $776.25 / $1,584.89	Facility		$275.42	$776.25	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $50.12 / $95.50	Professional		$35.48	$50.12	$95.50
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $263.03 / $263.03	Facility		$33.88	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $501.19 / $501.19	Professional		$48.98	$501.19	$501.19
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $57.54 / $131.83	Facility		$36.31	$57.54	$131.83
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $223.87 / $588.84 / $1,621.81	Facility	25	$223.87	$588.84	$1,621.81
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $52.48 / $83.18	Professional		$30.90	$52.48	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $32.36 / $33.11	Professional		$25.12	$32.36	$33.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $75.86 / $97.72	Professional		$41.69	$75.86	$97.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $56.23 / $128.82	Facility		$36.31	$56.23	$128.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $102.33	Professional		$36.31	$53.70	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $83.18	Professional		$33.11	$44.67	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $48.98	Professional		$41.69	$41.69	$48.98