Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $2,128.00 / $7,316.00	Facility		$500.00	$2,128.00	$7,316.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.77 / $132.07 / $189.41	Facility	26	$121.77	$132.07	$189.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.43 / $400.69 / $623.20	Professional		$341.43	$400.69	$623.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.66 / $132.07 / $225.07	Professional	26	$121.66	$132.07	$225.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.38 / $276.93 / $384.64	Professional	TC	$219.38	$276.93	$384.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $316.60 / $333.26 / $407.17	Professional		$316.60	$333.26	$407.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $219.96 / $383.45 / $1,543.89	Facility		$219.96	$383.45	$1,543.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.17 / $300.89 / $565.10	Professional		$114.17	$300.89	$565.10
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $387.66 / $735.41 / $1,128.13	Facility		$387.66	$735.41	$1,128.13
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $349.51 / $523.22 / $650.00	Professional		$349.51	$523.22	$650.00
Christus Facility/Professional Facility Modifier Low / Median / High Price $341.38 / $516.21 / $516.21	Facility		$341.38	$516.21	$516.21
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $123.86 / $358.92 / $358.92	Professional	26	$123.86	$358.92	$358.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $325.02 / $325.02 / $756.67	Facility		$325.02	$325.02	$756.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.57 / $474.07 / $733.69	Professional		$363.57	$474.07	$733.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.50 / $170.36 / $261.42	Professional	26	$131.50	$170.36	$261.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.90 / $304.56 / $491.33	Professional	TC	$228.90	$304.56	$491.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,891.36	Facility		$55.00	$55.00	$1,891.36
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $289.62 / $564.64 / $603.96	Facility	26	$289.62	$564.64	$603.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,582.80 / $2,844.40 / $3,019.05	Professional		$2,582.80	$2,844.40	$3,019.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $908.96 / $930.32 / $1,026.90	Professional	26	$908.96	$930.32	$1,026.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,745.64 / $1,914.08 / $1,992.15	Professional	TC	$1,745.64	$1,914.08	$1,992.15
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $349.92 / $447.34 / $780.08	Facility		$349.92	$447.34	$780.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $333.26 / $522.08 / $626.49	Professional		$333.26	$522.08	$626.49
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $156.85 / $184.59 / $217.17	Professional	26	$156.85	$184.59	$217.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.62 / $347.92 / $409.32	Professional	TC	$295.62	$347.92	$409.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $440.80 / $440.80 / $440.80	Professional		$440.80	$440.80	$440.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $349.92 / $451.69 / $798.47	Facility		$349.92	$451.69	$798.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $368.12 / $486.32 / $814.08	Professional		$368.12	$486.32	$814.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $132.97 / $171.84 / $261.42	Professional	26	$132.97	$171.84	$261.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $228.47 / $309.74 / $509.60	Professional	TC	$228.47	$309.74	$509.60
United Facility/Professional Facility Modifier Low / Median / High Price $369.00 / $1,529.00 / $3,400.00	Facility		$369.00	$1,529.00	$3,400.00
United Facility/Professional Professional Modifier Low / Median / High Price $289.74 / $395.10 / $646.76	Professional		$289.74	$395.10	$646.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.60 / $145.30 / $224.56	Professional	26	$104.60	$145.30	$224.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.99 / $252.99 / $417.00	Professional	TC	$181.99	$252.99	$417.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $297.05 / $333.26 / $471.84	Professional		$297.05	$333.26	$471.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $102.97 / $118.38 / $162.86	Professional	26	$102.97	$118.38	$162.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $194.08 / $214.88 / $308.95	Professional	TC	$194.08	$214.88	$308.95