Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $51.29 / $89.13	Facility		$40.74	$51.29	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $74.13	Professional		$32.36	$46.77	$74.13
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	25	$57.54	$57.54	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $60.26 / $70.79	Professional		$48.98	$60.26	$70.79
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $48.98 / $58.88 / $75.86	Professional	25	$48.98	$58.88	$75.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $77.62 / $162.18	Facility		$39.81	$77.62	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $43.65 / $58.88	Professional		$28.84	$43.65	$58.88
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $100.00	Professional		$52.48	$70.79	$100.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $61.66 / $61.66	Facility		$43.65	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $81.28	Professional		$33.11	$47.86	$81.28
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $398.11 / $398.11	Professional		$72.44	$398.11	$398.11
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $47.86 / $72.44	Facility		$35.48	$47.86	$72.44
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $81.28	Professional		$33.11	$48.98	$81.28
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $42.66 / $54.95 / $67.61	Professional	25	$42.66	$54.95	$67.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $47.86 / $69.18	Facility		$34.67	$47.86	$69.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $81.28	Professional		$33.11	$48.98	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $158.49 / $208.93	Facility		$154.88	$158.49	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $39.81 / $61.66	Professional		$28.84	$39.81	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $64.57 / $79.43	Professional		$28.18	$64.57	$79.43