Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.84 / $318.39 / $318.39	Facility		$74.84	$318.39	$318.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.19 / $118.75 / $195.46	Professional		$76.19	$118.75	$195.46
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $78.18 / $140.08 / $245.78	Professional	25	$78.18	$140.08	$245.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $127.06 / $146.12	Professional		$110.00	$127.06	$146.12
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $104.46 / $122.89 / $129.24	Professional	25	$104.46	$122.89	$129.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $110.59 / $110.59	Professional		$94.00	$110.59	$110.59
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $118.40 / $150.00 / $227.00	Professional		$118.40	$150.00	$227.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $123.58 / $123.58 / $134.65	Facility		$123.58	$123.58	$134.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $116.36	Professional		$116.36	$116.36	$116.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $223.36 / $667.49 / $667.49	Facility		$223.36	$667.49	$667.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $818.99 / $818.99 / $1,074.45	Professional		$818.99	$818.99	$1,074.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $94.20 / $132.66 / $244.27	Facility		$94.20	$132.66	$244.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $127.67 / $180.60 / $246.62	Professional		$127.67	$180.60	$246.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $126.63 / $145.62 / $248.52	Professional		$126.63	$145.62	$248.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $96.12 / $132.11 / $250.13	Facility		$96.12	$132.11	$250.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $132.11	Professional		$116.36	$116.36	$132.11
United Facility/Professional Professional Modifier Low / Median / High Price $90.85 / $121.67 / $181.85	Professional		$90.85	$121.67	$181.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.94 / $126.63 / $172.05	Professional		$107.94	$126.63	$172.05