Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.31 / $109.42 / $111.52	Facility		$107.31	$109.42	$111.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.21 / $113.63 / $232.46	Professional		$105.21	$113.63	$232.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.22 / $170.62 / $180.23	Professional		$168.22	$170.62	$180.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,456.92 / $5,821.21 / $8,577.84	Facility		$5,456.92	$5,821.21	$8,577.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.37 / $114.37 / $143.09	Professional		$114.37	$114.37	$143.09
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $148.52 / $192.25 / $240.31	Professional		$148.52	$192.25	$240.31
Christus Facility/Professional Facility Modifier Low / Median / High Price $240.31 / $240.31 / $240.31	Facility		$240.31	$240.31	$240.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.55 / $152.55 / $153.72	Facility		$152.55	$152.55	$153.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $111.36 / $152.55	Professional		$111.36	$111.36	$152.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $401.60 / $1,113.14 / $1,113.14	Facility		$401.60	$1,113.14	$1,113.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,203.42 / $1,203.42 / $1,749.75	Professional		$1,203.42	$1,203.42	$1,749.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $68.78 / $169.60 / $240.31	Facility		$68.78	$169.60	$240.31
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $68.78 / $212.72 / $240.31	Professional		$68.78	$212.72	$240.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $125.60 / $240.31 / $551.52	Professional		$125.60	$240.31	$551.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $68.78 / $160.57 / $240.31	Facility		$68.78	$160.57	$240.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $111.36 / $162.62	Professional		$111.36	$111.36	$162.62
United Facility/Professional Professional Modifier Low / Median / High Price $83.41 / $128.38 / $152.84	Professional		$83.41	$128.38	$152.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.05 / $127.94 / $240.31	Professional		$114.05	$127.94	$240.31