Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $173.78 / $27,542.29	Facility		$93.33	$173.78	$27,542.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $95.50 / $7,943.28	Professional		$93.33	$95.50	$7,943.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $93.33	Professional		$91.20	$91.20	$93.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $190.55 / $363.08	Facility		$77.62	$190.55	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $147.91 / $14,791.08	Facility		$75.86	$147.91	$14,791.08
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $102.33 / $138.04	Professional		$93.33	$102.33	$138.04
Christus Facility/Professional Facility Modifier Low / Median / High Price $13,182.57 / $13,182.57 / $13,182.57	Facility		$13,182.57	$13,182.57	$13,182.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $93.33 / $93.33	Facility		$89.13	$93.33	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $102.33 / $169.82	Facility		$93.33	$102.33	$169.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $141.25	Professional		$93.33	$93.33	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $91.20 / $104.71	Professional		$89.13	$91.20	$104.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $125.89 / $177.83	Professional		$0.60	$125.89	$177.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $97.72 / $165.96	Facility		$93.33	$97.72	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $107.15	Professional		$93.33	$93.33	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $93.33 / $93.33	Facility		$91.20	$93.33	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $100.00 / $104.71	Professional		$93.33	$100.00	$104.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $117.49	Professional		$89.13	$93.33	$117.49