Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $22.91 / $47.86	Facility		$19.95	$22.91	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $60.26	Professional		$19.95	$26.92	$60.26
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $27.54 / $57.54 / $138.04	Professional	25	$27.54	$57.54	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $29.51 / $39.81	Professional		$22.91	$29.51	$39.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $23.99 / $66.07	Facility		$23.99	$23.99	$66.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $30.20	Professional		$20.42	$25.70	$30.20
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $32.36 / $44.67	Professional		$24.55	$32.36	$44.67
Christus Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $24.55 / $30.20	Facility		$22.39	$24.55	$30.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $61.66	Professional		$26.30	$36.31	$61.66
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $28.84 / $48.98	Facility		$20.89	$28.84	$48.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $51.29	Professional		$19.95	$25.70	$51.29
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	25	$138.04	$138.04	$138.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $46.77 / $85.11	Professional		$23.44	$46.77	$85.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $29.51 / $48.98	Facility		$21.38	$29.51	$48.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.02 / $67.61	Professional		$26.30	$38.02	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $40.74	Facility		$36.31	$36.31	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $46.77	Professional		$22.91	$30.90	$46.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $29.51 / $33.88	Professional		$20.89	$29.51	$33.88