Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $239.88 / $3,548.13	Facility		$104.71	$239.88	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $338.84	Professional		$104.71	$104.71	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $151.36	Professional		$109.65	$109.65	$151.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $831.76 / $1,584.89	Facility		$331.13	$831.76	$1,584.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $162.18 / $2,398.83	Facility		$72.44	$162.18	$2,398.83
Christus Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $104.71 / $104.71	Facility		$97.72	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Professional		$1,698.24	$1,698.24	$1,698.24
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $109.65 / $537.03	Facility		$104.71	$109.65	$537.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $134.90	Professional		$104.71	$104.71	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $154.88	Professional		$109.65	$131.83	$154.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $128.82 / $446.68	Professional		$0.60	$128.82	$446.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $112.20 / $489.78	Facility		$104.71	$112.20	$489.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $102.33	Professional		$72.44	$72.44	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $109.65	Facility		$104.71	$104.71	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $117.49	Professional		$104.71	$109.65	$117.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $134.90	Professional		$104.71	$104.71	$134.90