Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $83.18 / $117.49	Facility		$58.88	$83.18	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $251.19	Professional		$61.66	$102.33	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $102.33 / $131.83	Professional		$83.18	$102.33	$131.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $169.82	Facility		$100.00	$100.00	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $107.15	Professional		$58.88	$79.43	$107.15
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $131.83	Professional		$72.44	$95.50	$131.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $104.71	Facility		$79.43	$79.43	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $107.15 / $186.21	Professional		$70.79	$107.15	$186.21
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Facility		$467.74	$467.74	$467.74
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $131.83 / $660.69	Professional		$104.71	$131.83	$660.69
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $100.00 / $173.78	Facility		$63.10	$100.00	$173.78
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $190.55	Professional		$60.26	$91.20	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $112.20	Professional		$63.10	$89.13	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $239.88	Professional		$79.43	$141.25	$239.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $97.72 / $173.78	Facility		$63.10	$97.72	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $199.53	Professional		$69.18	$107.15	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $109.65	Facility		$83.18	$83.18	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $138.04	Professional		$63.10	$91.20	$138.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $104.71 / $117.49	Professional		$52.48	$104.71	$117.49