Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $74.13 / $83.18	Facility	26	$46.77	$74.13	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $380.19 / $870.96	Professional		$218.78	$380.19	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $95.50 / $208.93	Professional	26	$53.70	$95.50	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $257.04 / $512.86	Professional	TC	$162.18	$257.04	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $181.97 / $295.12	Professional		$158.49	$181.97	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $54.95 / $104.71	Professional	26	$42.66	$54.95	$104.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $169.82 / $223.87	Professional		$45.71	$169.82	$223.87
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $223.87 / $588.84	Professional		$181.97	$223.87	$588.84
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $57.54	Professional	26	$53.70	$53.70	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $93.33	Facility	26	$13.80	$64.57	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $407.38 / $812.83	Professional		$204.17	$407.38	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $72.44 / $144.54	Professional	26	$47.86	$72.44	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $316.23 / $676.08	Professional	TC	$151.36	$316.23	$676.08
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	26	$524.81	$524.81	$524.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,951.21	Professional		$2,884.03	$2,884.03	$2,951.21
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $501.19 / $501.19 / $501.19	Professional	26	$501.19	$501.19	$501.19
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,570.40 / $2,570.40 / $2,691.53	Professional	TC	$2,570.40	$2,570.40	$2,691.53
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $74.13 / $83.18	Facility	26	$46.77	$74.13	$83.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $416.87 / $870.96	Professional		$218.78	$416.87	$870.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $102.33 / $218.78	Professional	26	$57.54	$102.33	$218.78
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $281.84 / $588.84	Professional	TC	$162.18	$281.84	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $177.83	Professional		$32.36	$33.11	$177.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $223.87 / $954.99	Professional		$58.88	$223.87	$954.99
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $93.33	Facility	26	$13.80	$64.57	$93.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $407.38 / $776.25	Professional		$204.17	$407.38	$776.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $69.18 / $134.90	Professional	26	$47.86	$69.18	$134.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $295.12 / $660.69	Professional	TC	$151.36	$295.12	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $389.05 / $676.08	Professional		$213.80	$389.05	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $104.71	Professional	26	$48.98	$61.66	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $309.03 / $549.54	Professional	TC	$162.18	$309.03	$549.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $257.04	Professional		$204.17	$204.17	$257.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $56.23 / $67.61	Professional	26	$53.70	$56.23	$67.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $190.55	Professional	TC	$151.36	$151.36	$190.55