Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $339.62 / $2,000.00 / $6,691.00	Facility		$339.62	$2,000.00	$6,691.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.58 / $41.85 / $59.46	Facility	26	$38.58	$41.85	$59.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.93 / $202.52 / $290.95	Professional		$140.93	$202.52	$290.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.56 / $42.03 / $81.23	Professional	26	$38.56	$42.03	$81.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.17 / $163.93 / $217.09	Professional	TC	$94.17	$163.93	$217.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.94 / $187.19 / $187.19	Professional		$145.94	$187.19	$187.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.95 / $372.03 / $8,427.00	Facility		$59.95	$372.03	$8,427.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.32 / $116.42 / $246.23	Professional		$31.32	$116.42	$246.23
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $184.42 / $229.69 / $1,492.96	Facility		$184.42	$229.69	$1,492.96
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $162.02 / $210.63 / $364.55	Professional		$162.02	$210.63	$364.55
Christus Facility/Professional Facility Modifier Low / Median / High Price $134.58 / $134.58 / $149.04	Facility		$134.58	$134.58	$149.04
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.82 / $106.07 / $106.07	Professional	26	$38.82	$106.07	$106.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.74 / $212.97 / $345.63	Professional		$151.74	$212.97	$345.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.26 / $54.59 / $91.47	Professional	26	$41.26	$54.59	$91.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.21 / $155.37 / $255.42	Professional	TC	$102.21	$155.37	$255.42
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $2,922.50	Facility		$55.00	$55.00	$2,922.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $101.27 / $181.86 / $190.52	Facility	26	$101.27	$181.86	$190.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,531.99 / $1,577.95 / $1,577.95	Professional		$1,531.99	$1,577.95	$1,577.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $684.00 / $907.84 / $907.84	Professional	26	$684.00	$907.84	$907.84
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,117.24 / $1,150.75 / $1,150.75	Professional	TC	$1,117.24	$1,150.75	$1,150.75
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $153.62 / $214.75 / $481.96	Facility		$153.62	$214.75	$481.96
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $153.62 / $241.64 / $289.95	Professional		$153.62	$241.64	$289.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.21 / $57.91 / $68.13	Professional	26	$49.21	$57.91	$68.13
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.21 / $197.18 / $225.53	Professional	TC	$160.21	$197.18	$225.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $381.30 / $381.30 / $381.30	Professional		$381.30	$381.30	$381.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $153.62 / $215.46 / $495.98	Facility		$153.62	$215.46	$495.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $150.88 / $213.68 / $387.15	Professional		$150.88	$213.68	$387.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $55.35 / $89.63	Professional	26	$42.06	$55.35	$89.63
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $99.83 / $154.69 / $255.42	Professional	TC	$99.83	$154.69	$255.42
United Facility/Professional Facility Modifier Low / Median / High Price $157.00 / $950.00 / $2,376.00	Facility		$157.00	$950.00	$2,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $101.83 / $166.37 / $294.44	Professional		$101.83	$166.37	$294.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.49 / $46.05 / $72.92	Professional	26	$33.49	$46.05	$72.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.77 / $123.74 / $209.12	Professional	TC	$64.77	$123.74	$209.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.49 / $153.62 / $218.73	Professional		$137.49	$153.62	$218.73
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $32.29 / $37.15 / $51.19	Professional	26	$32.29	$37.15	$51.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $105.18 / $116.46 / $167.54	Professional	TC	$105.18	$116.46	$167.54