Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.68 / $948.20 / $4,999.28	Facility		$152.68	$948.20	$4,999.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $167.94	Professional		$151.16	$151.16	$167.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.33 / $158.33 / $158.33	Professional		$150.33	$158.33	$158.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.47 / $286.61 / $722.01	Facility		$203.47	$286.61	$722.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.06 / $163.06 / $163.06	Professional		$163.06	$163.06	$163.06
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $148.62 / $172.88 / $1,118.35	Facility		$148.62	$172.88	$1,118.35
Christus Facility/Professional Facility Modifier Low / Median / High Price $121.37 / $289.44 / $289.44	Facility		$121.37	$289.44	$289.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.61 / $151.16 / $151.16	Facility		$142.61	$151.16	$151.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $151.16	Professional		$151.16	$151.16	$151.16
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $340.68 / $699.05 / $699.05	Facility		$340.68	$699.05	$699.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $699.05 / $699.05 / $699.05	Professional		$699.05	$699.05	$699.05
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $150.33 / $151.16 / $339.24	Facility		$150.33	$151.16	$339.24
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $188.96	Professional		$151.16	$151.16	$188.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $163.26 / $261.51 / $347.20	Professional		$163.26	$261.51	$347.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $151.16 / $151.16 / $338.60	Facility		$151.16	$151.16	$338.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $190.19	Professional		$151.16	$151.16	$190.19
United Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $153.13	Professional		$151.16	$151.16	$153.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $158.33 / $204.08	Professional		$151.16	$158.33	$204.08