Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.39 / $72.18 / $82.00	Facility	26	$46.39	$72.18	$82.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.50 / $353.00 / $573.75	Professional		$219.50	$353.00	$573.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.85 / $79.03 / $145.65	Professional	26	$52.85	$79.03	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.65 / $258.05 / $433.00	Professional	TC	$166.65	$258.05	$433.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $171.15 / $383.38	Professional		$171.15	$171.15	$383.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $88.23 / $90.49	Professional	26	$58.77	$88.23	$90.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.04 / $171.27 / $271.23	Professional		$49.04	$171.27	$271.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $224.64 / $305.52 / $362.78	Professional		$224.64	$305.52	$362.78
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $52.93 / $52.93 / $57.22	Professional	26	$52.93	$52.93	$57.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.36 / $428.90 / $810.44	Professional		$192.36	$428.90	$810.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.00 / $67.56 / $137.32	Professional	26	$44.00	$67.56	$137.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.18 / $314.56 / $686.91	Professional	TC	$145.18	$314.56	$686.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $409.92 / $516.48 / $530.79	Facility	26	$409.92	$516.48	$530.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,882.90 / $2,955.62 / $2,972.47	Professional		$2,882.90	$2,955.62	$2,972.47
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $596.05 / $596.05 / $596.05	Professional	26	$596.05	$596.05	$596.05
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,573.94 / $2,626.86 / $2,698.84	Professional	TC	$2,573.94	$2,626.86	$2,698.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $226.31 / $369.86 / $843.55	Professional		$226.31	$369.86	$843.55
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $89.66 / $217.36	Professional	26	$70.64	$89.66	$217.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $220.77 / $280.20 / $679.28	Professional	TC	$220.77	$280.20	$679.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $213.16 / $412.67	Professional		$60.59	$213.16	$412.67
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $209.11 / $438.89 / $778.31	Professional		$209.11	$438.89	$778.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.25 / $67.90 / $138.00	Professional	26	$47.25	$67.90	$138.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $148.02 / $304.50 / $686.91	Professional	TC	$148.02	$304.50	$686.91
United Facility/Professional Professional Modifier Low / Median / High Price $226.35 / $378.51 / $664.33	Professional		$226.35	$378.51	$664.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.97 / $61.35 / $104.53	Professional	26	$48.97	$61.35	$104.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.11 / $295.49 / $543.99	Professional	TC	$172.11	$295.49	$543.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $191.31 / $213.94 / $304.49	Professional		$191.31	$213.94	$304.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.38 / $53.47 / $73.80	Professional	26	$46.38	$53.47	$73.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $144.94 / $169.39 / $1,400.00	Professional	TC	$144.94	$169.39	$1,400.00