Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.90 / $217.47 / $303.99	Facility		$151.90	$217.47	$303.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.90 / $209.80 / $291.20	Professional		$151.90	$209.80	$291.20
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $210.64 / $294.05 / $473.40	Professional	25	$210.64	$294.05	$473.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.58 / $236.80 / $280.20	Professional		$170.58	$236.80	$280.20
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $179.06 / $264.33 / $280.20	Professional	25	$179.06	$264.33	$280.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.75 / $287.51 / $564.58	Facility		$143.75	$287.51	$564.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.04 / $194.74 / $273.80	Professional		$150.04	$194.74	$273.80
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $256.08 / $256.08 / $256.08	Facility		$256.08	$256.08	$256.08
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $188.01 / $264.33 / $350.35	Professional		$188.01	$264.33	$350.35
Christus Facility/Professional Facility Modifier Low / Median / High Price $108.71 / $108.71 / $262.62	Facility		$108.71	$108.71	$262.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.28 / $247.16 / $390.40	Professional		$164.28	$247.16	$390.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $853.77 / $927.58 / $927.58	Facility		$853.77	$927.58	$927.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.95 / $1,741.13 / $1,741.13	Professional		$1,202.95	$1,741.13	$1,741.13
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $151.90 / $217.47 / $303.99	Facility		$151.90	$217.47	$303.99
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $179.06 / $299.95 / $436.29	Professional		$179.06	$299.95	$436.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $219.83 / $219.83 / $328.88	Professional		$219.83	$219.83	$328.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.90 / $217.47 / $301.64	Facility		$151.90	$217.47	$301.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.06 / $251.17 / $395.03	Professional		$162.06	$251.17	$395.03
United Facility/Professional Professional Modifier Low / Median / High Price $185.42 / $247.94 / $376.11	Professional		$185.42	$247.94	$376.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $232.72 / $264.33 / $369.99	Professional		$232.72	$264.33	$369.99