Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $307.35 / $420.54	Facility		$207.13	$307.35	$420.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $208.19 / $248.55	Professional		$207.13	$208.19	$248.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $170.80 / $432.29 / $862.54	Facility		$170.80	$432.29	$862.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.90 / $209.90 / $209.90	Professional		$209.90	$209.90	$209.90
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $166.28 / $207.13 / $783.54	Facility		$166.28	$207.13	$783.54
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $80.00 / $210.78	Facility		$80.00	$80.00	$210.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.40 / $207.13 / $207.13	Facility		$195.40	$207.13	$207.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $207.13	Professional		$207.13	$207.13	$207.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $272.74 / $1,025.20 / $1,035.65	Facility		$272.74	$1,025.20	$1,035.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $904.64 / $904.64 / $904.64	Professional		$904.64	$904.64	$904.64
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $206.13 / $207.13 / $426.69	Facility		$206.13	$207.13	$426.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $211.27 / $341.76	Professional		$207.13	$211.27	$341.76
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $203.61 / $231.86 / $405.50	Professional		$203.61	$231.86	$405.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $207.13 / $207.13 / $369.72	Facility		$207.13	$207.13	$369.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $207.13 / $254.50	Professional		$207.13	$207.13	$254.50
United Facility/Professional Facility Modifier Low / Median / High Price $207.00 / $207.00 / $207.00	Facility		$207.00	$207.00	$207.00
United Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $219.56 / $230.58	Professional		$207.13	$219.56	$230.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.90 / $207.13 / $289.98	Professional		$204.90	$207.13	$289.98