Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.92 / $91.58 / $112.71	Facility	26	$69.92	$91.58	$112.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $301.92 / $475.00 / $833.74	Professional		$301.92	$475.00	$833.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.92 / $124.71 / $279.81	Professional	26	$69.92	$124.71	$279.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $232.01 / $335.00 / $557.79	Professional	TC	$232.01	$335.00	$557.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $274.82 / $343.52 / $684.80	Professional		$274.82	$343.52	$684.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.41 / $88.51 / $156.99	Professional	26	$64.41	$88.51	$156.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $263.04 / $411.77	Professional		$72.37	$263.04	$411.77
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $322.00 / $398.12 / $649.46	Professional		$322.00	$398.12	$649.46
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.69 / $79.69 / $86.30	Professional	26	$79.69	$79.69	$86.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.99 / $572.91 / $1,316.51	Professional		$291.99	$572.91	$1,316.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.09 / $101.83 / $181.93	Professional	26	$66.09	$101.83	$181.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.97 / $448.74 / $1,134.69	Professional	TC	$220.97	$448.74	$1,134.69
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $617.36 / $777.44 / $796.16	Facility	26	$617.36	$777.44	$796.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,311.18 / $5,470.52 / $5,470.52	Professional		$5,311.18	$5,470.52	$5,470.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $808.00 / $808.00 / $808.00	Professional	26	$808.00	$808.00	$808.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $4,858.99 / $5,004.77 / $5,004.77	Professional	TC	$4,858.99	$5,004.77	$5,004.77
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $183.91 / $510.44 / $1,361.16	Professional		$183.91	$510.44	$1,361.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $106.39 / $135.04 / $327.36	Professional	26	$106.39	$135.04	$327.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $335.99 / $426.44 / $1,033.80	Professional	TC	$335.99	$426.44	$1,033.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.59 / $340.35 / $679.98	Professional		$95.59	$340.35	$679.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $647.37 / $1,267.35	Professional		$317.47	$647.37	$1,267.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.20 / $101.85 / $177.78	Professional	26	$71.20	$101.85	$177.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $226.06 / $428.59 / $1,120.83	Professional	TC	$226.06	$428.59	$1,120.83
United Facility/Professional Professional Modifier Low / Median / High Price $343.95 / $584.80 / $1,077.29	Professional		$343.95	$584.80	$1,077.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.44 / $92.39 / $157.06	Professional	26	$73.44	$92.39	$157.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.98 / $476.75 / $835.54	Professional	TC	$257.98	$476.75	$835.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $290.43 / $324.73 / $462.24	Professional		$290.43	$324.73	$462.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $80.51 / $111.12	Professional	26	$69.84	$80.51	$111.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $220.58 / $257.81 / $1,400.00	Professional	TC	$220.58	$257.81	$1,400.00