Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $147.91	Facility		$100.00	$100.00	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $416.87	Professional		$95.50	$138.04	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $169.82	Professional		$104.71	$114.82	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $120.23	Professional		$87.10	$104.71	$120.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $245.47	Professional		$123.03	$147.91	$245.47
Christus Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $112.20	Facility		$104.71	$104.71	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $269.15	Professional		$109.65	$151.36	$269.15
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $758.58 / $758.58	Facility		$758.58	$758.58	$758.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $1,071.52 / $1,071.52	Professional		$138.04	$1,071.52	$1,071.52
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $134.90 / $269.15	Facility		$97.72	$134.90	$269.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $123.03 / $331.13	Professional		$95.50	$123.03	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $194.98 / $239.88	Professional		$109.65	$194.98	$239.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $147.91 / $269.15	Facility		$100.00	$147.91	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $295.12	Professional		$107.15	$154.88	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $194.98	Professional		$102.33	$134.90	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $128.82	Professional		$81.28	$107.15	$128.82