Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $309.03 / $416.87	Facility		$154.88	$309.03	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $251.19	Professional		$173.78	$173.78	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $245.47	Professional		$173.78	$173.78	$245.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $302.00 / $575.44	Facility		$123.03	$302.00	$575.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $288.40 / $6,606.93	Facility		$125.89	$288.40	$6,606.93
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $181.97 / $257.04	Professional		$102.33	$181.97	$257.04
Christus Facility/Professional Facility Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Facility		$6,165.95	$6,165.95	$6,165.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $173.78 / $173.78	Facility		$162.18	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Facility		$870.96	$870.96	$870.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $2,951.21 / $2,951.21	Professional		$2,951.21	$2,951.21	$2,951.21
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $281.84	Facility		$173.78	$173.78	$281.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $218.78	Professional		$173.78	$173.78	$218.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $199.53	Professional		$165.96	$173.78	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $173.78 / $295.12	Professional		$30.20	$173.78	$295.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $173.78 / $275.42	Facility		$112.20	$173.78	$275.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $199.53	Professional		$173.78	$173.78	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $186.21 / $194.98	Professional		$173.78	$186.21	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $218.78	Professional		$165.96	$173.78	$218.78