Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.55 / $271.76 / $379.48	Facility		$172.55	$271.76	$379.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $174.75 / $209.12	Professional		$173.03	$174.75	$209.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $241.57 / $241.57 / $241.57	Professional		$241.57	$241.57	$241.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.65 / $312.95 / $618.25	Facility		$123.65	$312.95	$618.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.55 / $187.55 / $187.55	Professional		$187.55	$187.55	$187.55
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $124.63 / $173.92 / $10,854.00	Facility		$124.63	$173.92	$10,854.00
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $101.85 / $180.44 / $256.52	Professional		$101.85	$180.44	$256.52
Christus Facility/Professional Facility Modifier Low / Median / High Price $6,234.09 / $6,234.09 / $6,234.09	Facility		$6,234.09	$6,234.09	$6,234.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.24 / $173.03 / $173.03	Facility		$163.24	$173.03	$173.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $173.03 / $173.03	Professional		$173.03	$173.03	$173.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $219.37 / $824.60 / $865.15	Facility		$219.37	$824.60	$865.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,975.90 / $2,975.90 / $2,975.90	Professional		$2,975.90	$2,975.90	$2,975.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $87.39 / $172.55 / $249.65	Facility		$87.39	$172.55	$249.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $176.49 / $285.50	Professional		$173.03	$176.49	$285.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $157.00 / $190.33 / $293.39	Professional		$157.00	$190.33	$293.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.10 / $173.03 / $255.54	Facility		$91.10	$173.03	$255.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $173.03 / $205.54	Professional		$173.03	$173.03	$205.54
United Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $183.41 / $192.62	Professional		$173.03	$183.41	$192.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.71 / $173.03 / $242.24	Professional		$165.71	$173.03	$242.24