Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $90.64	Facility		$89.75	$89.75	$90.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $92.44	Professional		$89.75	$89.75	$92.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.08 / $111.90 / $305.18	Facility		$85.08	$111.90	$305.18
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $94.77 / $4,311.01	Facility		$82.41	$94.77	$4,311.01
Christus Facility/Professional Facility Modifier Low / Median / High Price $117.28 / $121.37 / $121.37	Facility		$117.28	$121.37	$121.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $89.75 / $89.75	Facility		$84.67	$89.75	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Professional		$89.75	$89.75	$89.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,417.80 / $1,668.00 / $1,668.00	Facility		$1,417.80	$1,668.00	$1,668.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,668.00 / $1,884.84 / $1,884.84	Professional		$1,668.00	$1,884.84	$1,884.84
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $82.41 / $89.75 / $190.27	Facility		$82.41	$89.75	$190.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $112.19	Professional		$89.75	$89.75	$112.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.93 / $124.75 / $302.94	Professional		$96.93	$124.75	$302.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $189.91	Facility		$89.75	$89.75	$189.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $91.78	Professional		$89.75	$89.75	$91.78
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $90.92	Professional		$89.75	$89.75	$90.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $89.75 / $121.16	Professional		$73.42	$89.75	$121.16