Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $134.90 / $263.03	Facility		$102.33	$134.90	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $323.59	Professional		$102.33	$147.91	$323.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $162.18 / $204.17	Professional		$131.83	$162.18	$204.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $309.03	Facility		$117.49	$117.49	$309.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $165.96	Professional		$100.00	$125.89	$165.96
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $213.80	Professional		$120.23	$169.82	$213.80
Christus Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $162.18	Facility		$114.82	$114.82	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $295.12	Professional		$120.23	$169.82	$295.12
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Facility		$776.25	$776.25	$776.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Professional		$1,023.29	$1,023.29	$1,023.29
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $162.18 / $281.84	Facility		$104.71	$162.18	$281.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $281.84	Professional		$102.33	$144.54	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $128.82	Professional		$72.44	$102.33	$128.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $239.88 / $371.54	Professional		$120.23	$239.88	$371.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $162.18 / $281.84	Facility		$104.71	$162.18	$281.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $323.59	Professional		$117.49	$173.78	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $190.55	Facility		$141.25	$141.25	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $223.87	Professional		$107.15	$147.91	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $162.18 / $186.21	Professional		$93.33	$162.18	$186.21