Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $210.45 / $398.92	Facility		$112.45	$210.45	$398.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $113.58 / $176.69	Professional		$112.45	$113.58	$176.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.93 / $433.03 / $864.00	Facility		$177.93	$433.03	$864.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.57 / $133.57 / $133.57	Professional		$133.57	$133.57	$133.57
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $132.63 / $519.29 / $849.71	Facility		$132.63	$519.29	$849.71
Christus Facility/Professional Facility Modifier Low / Median / High Price $129.90 / $129.90 / $129.90	Facility		$129.90	$129.90	$129.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $112.45 / $112.45	Facility		$106.09	$112.45	$112.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $407.91 / $701.55 / $701.55	Facility		$407.91	$701.55	$701.55
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $113.58 / $148.53 / $165.64	Facility		$113.58	$148.53	$165.64
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.86 / $112.45 / $218.43	Professional		$85.86	$112.45	$218.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $112.45 / $162.41	Facility		$106.09	$112.45	$162.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $106.37 / $112.45 / $204.03	Professional		$106.37	$112.45	$204.03
United Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $120.68 / $151.81	Professional		$112.45	$120.68	$151.81