Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.26 / $166.31 / $357.67	Facility		$162.26	$166.31	$357.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.26 / $166.31 / $172.40	Professional		$162.26	$166.31	$172.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.82 / $202.82 / $202.82	Professional		$202.82	$202.82	$202.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.44 / $345.33 / $682.20	Facility		$136.44	$345.33	$682.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.37 / $170.37 / $170.37	Professional		$170.37	$170.37	$170.37
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $172.22 / $215.28 / $20,750.75	Facility		$172.22	$215.28	$20,750.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.40 / $172.40 / $172.40	Facility		$172.40	$172.40	$172.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.40 / $172.40 / $172.40	Professional		$172.40	$172.40	$172.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $192.68 / $858.90 / $858.90	Facility		$192.68	$858.90	$858.90
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $726.48 / $770.72 / $886.14	Professional		$726.48	$770.72	$886.14
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $164.38 / $164.38 / $407.70	Facility		$164.38	$164.38	$407.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $169.02 / $169.02 / $169.02	Professional		$169.02	$169.02	$169.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $239.47 / $294.64 / $316.05	Professional		$239.47	$294.64	$316.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $164.38 / $172.40 / $352.58	Facility		$164.38	$172.40	$352.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.40 / $172.40 / $172.40	Professional		$172.40	$172.40	$172.40
United Facility/Professional Facility Modifier Low / Median / High Price $206.25 / $278.95 / $278.95	Facility		$206.25	$278.95	$278.95
United Facility/Professional Professional Modifier Low / Median / High Price $202.82 / $202.82 / $243.38	Professional		$202.82	$202.82	$243.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.02 / $169.02 / $228.18	Professional		$169.02	$169.02	$228.18