Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.70 / $95.70 / $136.71	Facility		$95.70	$95.70	$136.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.10 / $156.18 / $264.25	Professional		$113.10	$156.18	$264.25
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $182.00 / $260.77	Professional	25	$115.53	$182.00	$260.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.76 / $156.18 / $172.28	Professional		$132.76	$156.18	$172.28
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $132.76 / $156.18 / $165.55	Professional	25	$132.76	$156.18	$165.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.20 / $141.41 / $141.41	Professional		$120.20	$141.41	$141.41
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $138.97 / $192.85 / $288.93	Professional		$138.97	$192.85	$288.93
Christus Facility/Professional Facility Modifier Low / Median / High Price $158.94 / $158.94 / $170.47	Facility		$158.94	$158.94	$170.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $285.58 / $842.92 / $842.92	Facility		$285.58	$842.92	$842.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,045.69 / $1,045.69 / $1,358.33	Professional		$1,045.69	$1,045.69	$1,358.33
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $129.57 / $172.15 / $320.54	Facility		$129.57	$172.15	$320.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $176.48 / $229.11 / $298.42	Professional		$176.48	$229.11	$298.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $160.71 / $185.00 / $315.33	Professional		$160.71	$185.00	$315.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $129.57 / $173.44 / $320.54	Facility		$129.57	$173.44	$320.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $194.71	Professional		$147.60	$147.60	$194.71
United Facility/Professional Professional Modifier Low / Median / High Price $136.13 / $181.21 / $274.92	Professional		$136.13	$181.21	$274.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $136.93 / $160.71 / $218.65	Professional		$136.93	$160.71	$218.65