Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.50 / $184.60 / $792.12	Facility		$61.50	$184.60	$792.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.06 / $158.28	Professional		$40.65	$41.06	$158.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $41.20 / $53.56	Professional		$41.20	$41.20	$53.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.39 / $233.58 / $475.75	Facility		$91.39	$233.58	$475.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $46.62 / $46.62	Professional		$46.62	$46.62	$46.62
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $44.32 / $44.32 / $92.70	Facility		$44.32	$44.32	$92.70
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $42.16 / $78.33	Professional		$40.65	$42.16	$78.33
Christus Facility/Professional Facility Modifier Low / Median / High Price $500.08 / $500.08 / $500.08	Facility		$500.08	$500.08	$500.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.35 / $40.65 / $40.65	Facility		$38.35	$40.65	$40.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $40.65	Professional		$40.65	$40.65	$40.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $163.92 / $192.85 / $192.85	Facility		$163.92	$192.85	$192.85
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,627.92 / $1,627.92 / $1,627.92	Professional		$1,627.92	$1,627.92	$1,627.92
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $41.87 / $103.10	Facility		$40.65	$41.87	$103.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $50.81 / $75.31	Professional		$40.65	$50.81	$75.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.21 / $44.72 / $90.47	Professional		$40.21	$44.72	$90.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.65 / $41.06 / $97.87	Facility		$40.65	$41.06	$97.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $53.34	Professional		$40.65	$40.65	$53.34
United Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $40.65 / $41.91	Professional		$40.65	$40.65	$41.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $41.61 / $54.88	Professional		$40.65	$41.61	$54.88