Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.94 / $131.56 / $227.39	Facility	26	$82.94	$131.56	$227.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.12 / $475.00 / $821.52	Professional		$298.12	$475.00	$821.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.94 / $140.00 / $322.44	Professional	26	$82.94	$140.00	$322.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $215.18 / $335.00 / $532.14	Professional	TC	$215.18	$335.00	$532.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $264.17 / $337.23 / $569.23	Professional		$264.17	$337.23	$569.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.37 / $106.36 / $188.58	Professional	26	$77.37	$106.36	$188.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $177.77 / $177.77 / $177.77	Professional	TC	$177.77	$177.77	$177.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.20 / $260.61 / $403.22	Professional		$83.20	$260.61	$403.22
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $314.08 / $436.11 / $754.81	Professional		$314.08	$436.11	$754.81
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $95.73 / $95.73 / $102.72	Professional	26	$95.73	$95.73	$102.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $286.64 / $522.41 / $1,272.21	Professional		$286.64	$522.41	$1,272.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.56 / $121.02 / $211.60	Professional	26	$79.56	$121.02	$211.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.82 / $385.00 / $1,027.64	Professional	TC	$200.82	$385.00	$1,027.64
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $742.64 / $932.32 / $950.80	Facility	26	$742.64	$932.32	$950.80
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,981.06 / $6,160.49 / $6,160.49	Professional		$5,981.06	$6,160.49	$6,160.49
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $883.52 / $883.52 / $883.52	Professional	26	$883.52	$883.52	$883.52
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $5,438.76 / $5,601.93 / $5,601.93	Professional	TC	$5,438.76	$5,601.93	$5,601.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $153.18 / $550.26 / $1,333.96	Professional		$153.18	$550.26	$1,333.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $127.83 / $162.24 / $393.32	Professional	26	$127.83	$162.24	$393.32
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $305.70 / $388.01 / $940.64	Professional	TC	$305.70	$388.01	$940.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.68 / $282.95 / $512.38	Professional		$108.68	$282.95	$512.38
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $116.17	Facility	26	$116.17	$116.17	$116.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $310.49 / $572.30 / $1,101.48	Professional		$310.49	$572.30	$1,101.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $85.33 / $121.14 / $205.68	Professional	26	$85.33	$121.14	$205.68
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $210.62 / $370.89 / $982.79	Professional	TC	$210.62	$370.89	$982.79
United Facility/Professional Professional Modifier Low / Median / High Price $336.21 / $510.47 / $1,067.96	Professional		$336.21	$510.47	$1,067.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.29 / $109.35 / $207.20	Professional	26	$87.29	$109.35	$207.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.26 / $385.61 / $785.93	Professional	TC	$243.26	$385.61	$785.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $284.62 / $318.92 / $452.88	Professional		$284.62	$318.92	$452.88
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $83.92 / $96.71 / $133.38	Professional	26	$83.92	$96.71	$133.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $200.70 / $234.60 / $1,400.00	Professional	TC	$200.70	$234.60	$1,400.00