Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.41 / $21.30 / $92.58	Facility		$13.41	$21.30	$92.58
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $109.16 / $109.16 / $114.62	Facility	25	$109.16	$109.16	$114.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.54 / $22.81 / $30.48	Professional		$16.54	$22.81	$30.48
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $42.84 / $42.84 / $42.84	Professional	25	$42.84	$42.84	$42.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $28.56 / $31.01	Professional		$5.00	$28.56	$31.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $19.57 / $21.89	Professional		$18.60	$19.57	$21.89
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $18.72 / $35.65 / $41.86	Professional		$18.72	$35.65	$41.86
Christus Facility/Professional Facility Modifier Low / Median / High Price $26.13 / $34.15 / $34.15	Facility		$26.13	$34.15	$34.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.16 / $29.16 / $33.33	Professional		$29.16	$29.16	$33.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $151.53 / $151.53 / $151.53	Facility		$151.53	$151.53	$151.53
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $155.88 / $187.97 / $267.30	Professional		$155.88	$187.97	$267.30
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $16.54 / $24.67 / $34.11	Facility		$16.54	$24.67	$34.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $42.16 / $56.70	Professional		$33.47	$42.16	$56.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.14 / $39.40 / $54.24	Professional		$30.14	$39.40	$54.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $16.54 / $24.61 / $33.96	Facility		$16.54	$24.61	$33.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.16 / $29.16 / $60.23	Professional		$29.16	$29.16	$60.23
United Facility/Professional Professional Modifier Low / Median / High Price $20.03 / $27.71 / $45.41	Professional		$20.03	$27.71	$45.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.05 / $31.76 / $43.41	Professional		$27.05	$31.76	$43.41