Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $60.26 / $120.23	Facility		$57.54	$60.26	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $158.49	Professional		$56.23	$70.79	$158.49
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $120.23 / $245.47	Professional	25	$58.88	$120.23	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $85.11	Professional		$54.95	$69.18	$85.11
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $63.10 / $69.18 / $69.18	Professional	25	$63.10	$69.18	$69.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $194.98 / $380.19	Facility		$91.20	$194.98	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $64.57 / $72.44	Professional		$53.70	$64.57	$72.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $83.18 / $134.90	Professional		$63.10	$83.18	$134.90
Christus Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $109.65 / $109.65	Facility		$63.10	$109.65	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $154.88	Professional		$60.26	$85.11	$154.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $85.11 / $144.54	Facility		$57.54	$85.11	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $141.25	Professional		$56.23	$70.79	$141.25
Moda Health Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $109.65 / $245.47	Professional	25	$58.88	$109.65	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $128.82 / $234.42	Professional		$66.07	$128.82	$234.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $79.43 / $138.04	Facility		$57.54	$79.43	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $173.78	Professional		$60.26	$87.10	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $120.23	Professional		$60.26	$79.43	$120.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $85.11	Professional		$58.88	$75.86	$85.11