Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.03 / $168.81 / $253.51	Facility		$112.03	$168.81	$253.51
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $186.71 / $186.71 / $186.71	Facility	25	$186.71	$186.71	$186.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.03 / $148.02 / $213.54	Professional		$112.03	$148.02	$213.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $149.58 / $240.52 / $370.68	Professional	25	$149.58	$240.52	$370.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.74 / $174.23 / $206.72	Professional		$131.74	$174.23	$206.72
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $195.01 / $195.01 / $208.32	Professional	25	$195.01	$195.01	$208.32
BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.52 / $308.37 / $574.09	Facility		$127.52	$308.37	$574.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.77 / $137.61 / $201.92	Professional		$86.77	$137.61	$201.92
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $140.79 / $300.55 / $325.89	Facility		$140.79	$300.55	$325.89
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $138.33 / $204.76 / $257.83	Professional		$138.33	$204.76	$257.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $112.40 / $112.40 / $193.76	Facility		$112.40	$112.40	$193.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.34 / $179.22 / $289.61	Professional		$119.34	$179.22	$289.61
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $628.24 / $683.24 / $683.24	Facility		$628.24	$683.24	$683.24
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $887.76 / $1,291.38 / $1,291.38	Professional		$887.76	$1,291.38	$1,291.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $112.03 / $161.19 / $224.26	Facility		$112.03	$161.19	$224.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.74 / $221.32 / $321.92	Professional		$131.74	$221.32	$321.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $161.78 / $161.78 / $242.70	Professional		$161.78	$161.78	$242.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.03 / $160.19 / $222.58	Facility		$112.03	$160.19	$222.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.88 / $183.31 / $289.61	Professional		$119.88	$183.31	$289.61
United Facility/Professional Professional Modifier Low / Median / High Price $132.34 / $183.15 / $262.50	Professional		$132.34	$183.15	$262.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $171.72 / $195.01 / $273.04	Professional		$171.72	$195.01	$273.04