Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $194.79 / $194.79 / $210.37	Facility		$194.79	$194.79	$210.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.32 / $207.09 / $389.58	Professional		$170.32	$207.09	$389.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $265.08 / $311.44 / $333.69	Professional		$265.08	$311.44	$333.69
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 $211.74 / $211.74 / $264.91	Professional		$211.74	$211.74	$264.91
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $311.44 / $333.68 / $444.91	Professional		$311.44	$333.68	$444.91
Christus Facility/Professional Facility Modifier Low / Median / High Price $306.75 / $306.75 / $444.91	Facility		$306.75	$306.75	$444.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $209.59 / $209.59 / $209.59	Facility		$209.59	$209.59	$209.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $209.59	Professional		$153.00	$153.00	$209.59
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $667.37 / $1,729.07 / $1,729.07	Facility		$667.37	$1,729.07	$1,729.07
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,202.30 / $2,202.30 / $2,960.93	Professional		$2,202.30	$2,202.30	$2,960.93
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $107.47 / $310.06 / $444.91	Facility		$107.47	$310.06	$444.91
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $108.69 / $378.17 / $444.91	Professional		$108.69	$378.17	$444.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $107.47 / $297.27 / $444.91	Facility		$107.47	$297.27	$444.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $153.00 / $230.00	Professional		$153.00	$153.00	$230.00
United Facility/Professional Facility Modifier Low / Median / High Price $128.27 / $221.96 / $256.52	Facility		$128.27	$221.96	$256.52
United Facility/Professional Professional Modifier Low / Median / High Price $138.72 / $205.22 / $250.82	Professional		$138.72	$205.22	$250.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $201.92 / $202.82 / $444.91	Professional		$201.92	$202.82	$444.91