Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $242.64 / $4,268.02	Facility		$106.33	$242.64	$4,268.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $107.40 / $298.14	Professional		$106.33	$107.40	$298.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $127.60 / $163.60	Professional		$106.33	$127.60	$163.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $386.19 / $1,113.33 / $10,950.19	Facility		$386.19	$1,113.33	$10,950.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.21 / $185.21 / $185.21	Professional		$185.21	$185.21	$185.21
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $334.00 / $1,596.06	Facility		$106.33	$334.00	$1,596.06
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $116.96 / $204.06 / $424.85	Professional		$116.96	$204.06	$424.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $2,126.16 / $2,126.16 / $2,126.16	Facility		$2,126.16	$2,126.16	$2,126.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.32 / $106.33 / $196.55	Facility		$100.32	$106.33	$196.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $110.35	Professional		$106.33	$106.33	$110.35
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $417.50 / $1,433.35 / $1,433.35	Facility		$417.50	$1,433.35	$1,433.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,358.07 / $1,358.07 / $1,358.07	Professional		$1,358.07	$1,358.07	$1,358.07
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $347.06	Facility		$106.33	$136.04	$347.06
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $108.46 / $175.44	Professional		$106.33	$108.46	$175.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $152.27 / $259.18	Professional		$106.33	$152.27	$259.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $106.33 / $344.00	Facility		$106.33	$106.33	$344.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $188.48	Professional		$106.33	$106.33	$188.48
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $112.71 / $118.37	Professional		$106.33	$112.71	$118.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $135.55 / $149.63	Professional		$106.33	$135.55	$149.63