Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.50 / $171.64 / $180.33	Facility		$77.50	$171.64	$180.33
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $171.41 / $171.41 / $176.82	Facility	25	$171.41	$171.41	$176.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.45 / $130.66 / $193.00	Professional		$95.45	$130.66	$193.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $170.76 / $261.39 / $261.39	Professional	25	$170.76	$261.39	$261.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $156.49 / $185.63	Professional		$154.57	$156.49	$185.63
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $133.02 / $156.49 / $156.49	Professional	25	$133.02	$156.49	$156.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.69 / $323.33 / $533.21	Facility		$113.69	$323.33	$533.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.98 / $120.44 / $141.69	Professional		$94.98	$120.44	$141.69
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $82.40 / $82.40 / $82.40	Facility		$82.40	$82.40	$82.40
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $123.48 / $172.87 / $246.96	Professional		$123.48	$172.87	$246.96
Christus Facility/Professional Facility Modifier Low / Median / High Price $113.13 / $113.54 / $113.54	Facility		$113.13	$113.54	$113.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $653.54 / $653.54 / $653.54	Facility		$653.54	$653.54	$653.54
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $828.70 / $1,045.69 / $1,361.18	Professional		$828.70	$1,045.69	$1,361.18
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.30 / $157.30 / $273.52	Facility		$108.30	$157.30	$273.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $157.29 / $208.99 / $289.37	Professional		$157.29	$208.99	$289.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.91 / $169.95 / $287.47	Professional		$116.91	$169.95	$287.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.30 / $157.25 / $279.97	Facility		$108.30	$157.25	$279.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $356.96	Professional		$147.90	$147.90	$356.96
United Facility/Professional Professional Modifier Low / Median / High Price $124.71 / $166.73 / $247.17	Professional		$124.71	$166.73	$247.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.19 / $161.04 / $219.09	Professional		$137.19	$161.04	$219.09