Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.80 / $119.30 / $273.64	Facility		$114.80	$119.30	$273.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.10 / $119.30 / $150.82	Professional		$99.10	$119.30	$150.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.52 / $182.52 / $182.52	Professional		$182.52	$182.52	$182.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $153.07 / $153.07	Professional		$122.34	$153.07	$153.07
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $179.95 / $192.80 / $257.07	Professional		$179.95	$192.80	$257.07
Christus Facility/Professional Facility Modifier Low / Median / High Price $257.07 / $257.07 / $257.07	Facility		$257.07	$257.07	$257.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.33 / $138.33 / $203.46	Facility		$138.33	$138.33	$203.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $100.98 / $100.98	Professional		$100.98	$100.98	$100.98
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $365.79 / $969.09 / $969.09	Facility		$365.79	$969.09	$969.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,272.50 / $1,272.50 / $1,446.00	Professional		$1,272.50	$1,272.50	$1,446.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $171.76 / $257.07	Facility		$62.10	$171.76	$257.07
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $218.51 / $257.07	Professional		$62.10	$218.51	$257.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $301.54 / $420.85	Professional		$72.50	$301.54	$420.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $171.76 / $257.07	Facility		$62.10	$171.76	$257.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $100.98 / $174.07	Professional		$100.98	$100.98	$174.07
United Facility/Professional Professional Modifier Low / Median / High Price $80.16 / $115.91 / $137.99	Professional		$80.16	$115.91	$137.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $115.51 / $119.57 / $257.07	Professional		$115.51	$119.57	$257.07