Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.45 / $396.17 / $3,901.00	Facility		$106.45	$396.17	$3,901.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $624.00 / $978.37 / $3,843.87	Facility	25	$624.00	$978.37	$3,843.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.65 / $120.65 / $208.72	Professional		$94.65	$120.65	$208.72
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $99.38 / $280.42 / $546.51	Professional	25	$99.38	$280.42	$546.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.81 / $212.77 / $373.15	Professional		$114.81	$212.77	$373.15
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $111.54 / $291.14 / $373.15	Professional	25	$111.54	$291.14	$373.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.60 / $87.60 / $2,140.00	Facility		$87.60	$87.60	$2,140.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.22 / $112.59 / $171.07	Professional		$93.22	$112.59	$171.07
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $134.33 / $291.23 / $536.00	Facility		$134.33	$291.23	$536.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $116.49 / $155.33 / $401.84	Professional		$116.49	$155.33	$401.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $116.92 / $251.92 / $251.92	Facility		$116.92	$251.92	$251.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,072.00 / $1,479.00 / $4,184.00	Facility		$1,072.00	$1,479.00	$4,184.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.65 / $147.47 / $265.69	Professional		$104.65	$147.47	$265.69
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $160.72 / $544.99 / $573.99	Facility		$160.72	$544.99	$573.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $175.58 / $748.12 / $748.12	Professional		$175.58	$748.12	$748.12
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.53 / $141.94 / $353.97	Facility		$108.53	$141.94	$353.97
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $133.91 / $209.61 / $892.50	Professional		$133.91	$209.61	$892.50
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $458.00 / $458.00 / $458.00	Facility		$458.00	$458.00	$458.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.33 / $145.59 / $229.03	Professional		$116.33	$145.59	$229.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.53 / $141.94 / $353.97	Facility		$108.53	$141.94	$353.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.42 / $154.63 / $289.95	Professional		$109.42	$154.63	$289.95
United Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $126.18 / $233.23	Professional		$91.77	$126.18	$233.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.39 / $116.47 / $160.72	Professional		$99.39	$116.47	$160.72