Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $91.20 / $123.03	Facility	26	$67.61	$91.20	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $398.11 / $776.25	Professional		$251.19	$398.11	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $102.33 / $194.98	Professional	26	$61.66	$102.33	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $281.84 / $501.19	Professional	TC	$177.83	$281.84	$501.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $114.82 / $120.23	Professional	26	$53.70	$114.82	$120.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $181.97 / $263.03	Professional		$58.88	$181.97	$263.03
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $316.23 / $457.09	Professional		$234.42	$316.23	$457.09
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $67.61 / $70.79	Professional	26	$66.07	$67.61	$70.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $81.28 / $114.82	Facility	26	$17.38	$81.28	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $457.09 / $870.96	Professional		$234.42	$457.09	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $79.43 / $165.96	Professional	26	$50.12	$79.43	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $338.84 / $707.95	Professional	TC	$169.82	$338.84	$707.95
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	26	$645.65	$645.65	$645.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $3,090.30	Professional		$2,884.03	$2,884.03	$3,090.30
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $602.56 / $602.56 / $870.96	Professional	26	$602.56	$602.56	$870.96
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,570.40 / $2,570.40 / $2,818.38	Professional	TC	$2,570.40	$2,570.40	$2,818.38
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $91.20 / $123.03	Facility	26	$57.54	$91.20	$123.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $870.96	Professional		$251.19	$426.58	$870.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $245.47	Professional	26	$70.79	$112.20	$245.47
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $288.40 / $549.54	Professional	TC	$177.83	$288.40	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $204.17	Professional		$32.36	$33.11	$204.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $251.19 / $1,023.29	Professional		$72.44	$251.19	$1,023.29
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $81.28 / $114.82	Facility	26	$17.38	$81.28	$114.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $457.09 / $812.83	Professional		$234.42	$457.09	$812.83
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $151.36	Professional	26	$50.12	$77.62	$151.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $323.59 / $691.83	Professional	TC	$162.18	$323.59	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $416.87 / $707.95	Professional		$245.47	$416.87	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $72.44 / $123.03	Professional	26	$48.98	$72.44	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $323.59 / $588.84	Professional	TC	$177.83	$323.59	$588.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $295.12	Professional		$234.42	$234.42	$295.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $70.79 / $83.18	Professional	26	$67.61	$70.79	$83.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $165.96 / $208.93	Professional	TC	$165.96	$165.96	$208.93