Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $263.03 / $6,165.95	Facility		$173.78	$263.03	$6,165.95
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,659.59 / $3,388.44 / $6,456.54	Facility	25	$1,659.59	$3,388.44	$6,456.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $724.44	Professional		$173.78	$245.47	$724.44
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $346.74 / $954.99	Professional	25	$190.55	$346.74	$954.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $223.87 / $501.19	Professional		$177.83	$223.87	$501.19
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $190.55 / $234.42 / $524.81	Professional	25	$190.55	$234.42	$524.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $3,019.95 / $5,370.32	Facility		$660.69	$3,019.95	$5,370.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $269.15	Professional		$173.78	$208.93	$269.15
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $354.81 / $354.81 / $2,238.72	Facility		$354.81	$354.81	$2,238.72
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $275.42 / $602.56	Professional		$208.93	$275.42	$602.56
Christus Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $295.12 / $302.00	Facility		$194.98	$295.12	$302.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $1,479.11 / $3,311.31	Facility		$331.13	$1,479.11	$3,311.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $302.00 / $524.81	Professional		$208.93	$302.00	$524.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $478.63 / $1,348.96	Facility		$302.00	$478.63	$1,348.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $323.59 / $1,737.80	Professional		$245.47	$323.59	$1,737.80
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $302.00 / $602.56	Facility		$194.98	$302.00	$602.56
Moda Health Facility/Professional Facility Modifier 25 Low / Median / High Price $1,096.48 / $2,454.71 / $6,309.57	Facility	25	$1,096.48	$2,454.71	$6,309.57
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $562.34	Professional		$173.78	$251.19	$562.34
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $181.97 / $346.74 / $954.99	Professional	25	$181.97	$346.74	$954.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $213.80	Professional		$32.36	$33.11	$213.80
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 $218.78 / $457.09 / $724.44	Professional		$218.78	$457.09	$724.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $302.00 / $562.34	Facility		$194.98	$302.00	$562.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $302.00 / $575.44	Professional		$208.93	$302.00	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $416.87	Professional		$190.55	$263.03	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $302.00 / $338.84	Professional		$162.18	$302.00	$338.84