Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.16 / $77.34 / $107.46	Facility		$59.16	$77.34	$107.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.86 / $62.75 / $98.37	Professional		$56.86	$62.75	$98.37
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.50 / $183.48 / $245.55	Professional	25	$58.50	$183.48	$245.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $70.59 / $89.46	Professional		$67.56	$70.59	$89.46
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.56 / $82.59 / $82.59	Professional	25	$67.56	$82.59	$82.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.88 / $258.07 / $339.17	Facility		$76.88	$258.07	$339.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.20 / $66.36 / $75.66	Professional		$55.20	$66.36	$75.66
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $68.81 / $87.44 / $108.10	Professional		$68.81	$87.44	$108.10
Christus Facility/Professional Facility Modifier Low / Median / High Price $62.78 / $108.71 / $108.71	Facility		$62.78	$108.71	$108.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.80 / $94.80 / $94.80	Facility		$94.80	$94.80	$94.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.86 / $81.17 / $133.81	Professional		$59.86	$81.17	$133.81
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $320.91 / $348.46 / $348.46	Facility		$320.91	$348.46	$348.46
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $450.62 / $450.62 / $454.95	Professional		$450.62	$450.62	$454.95
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.40 / $72.09 / $135.43	Facility		$57.40	$72.09	$135.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $99.43 / $128.15	Professional		$80.43	$99.43	$128.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $79.40 / $131.77	Professional		$65.06	$79.40	$131.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.40 / $72.16 / $160.13	Facility		$57.40	$72.16	$160.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $88.34 / $175.13	Professional		$62.30	$88.34	$175.13
United Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $79.42 / $118.63	Professional		$57.11	$79.42	$118.63
United Facility/Professional Professional Modifier 25 Low / Median / High Price $94.07 / $94.07 / $94.07	Professional	25	$94.07	$94.07	$94.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $69.04 / $94.58	Professional		$58.80	$69.04	$94.58