Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.08 / $90.49 / $123.32	Facility	26	$69.08	$90.49	$123.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $387.47 / $638.00	Professional		$250.00	$387.47	$638.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $109.67 / $171.39	Professional	26	$69.08	$109.67	$171.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $182.26 / $267.82 / $440.00	Professional	TC	$182.26	$267.82	$440.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $80.47 / $138.65	Professional	26	$64.37	$80.47	$138.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $208.83 / $335.19	Professional		$72.56	$208.83	$335.19
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $254.69 / $292.89 / $392.00	Professional		$254.69	$292.89	$392.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.66 / $79.66 / $85.60	Professional	26	$79.66	$79.66	$85.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.82 / $96.82 / $96.82	Facility	26	$96.82	$96.82	$96.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.95 / $435.00 / $888.18	Professional		$228.95	$435.00	$888.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $102.49 / $182.14	Professional	26	$66.73	$102.49	$182.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.52 / $305.77 / $717.54	Professional	TC	$157.52	$305.77	$717.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $618.08 / $775.84 / $792.16	Facility	26	$618.08	$775.84	$792.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,447.72 / $3,551.15 / $3,551.15	Professional		$3,447.72	$3,551.15	$3,551.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $665.40 / $665.40 / $683.93	Professional	26	$665.40	$665.40	$683.93
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,996.90 / $3,086.80 / $3,086.80	Professional	TC	$2,996.90	$3,086.80	$3,086.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $332.76 / $439.25 / $648.74	Professional		$332.76	$439.25	$648.74
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 $239.69 / $304.23 / $737.52	Professional	TC	$239.69	$304.23	$737.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $90.78 / $223.74 / $449.97	Professional		$90.78	$223.74	$449.97
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.82 / $96.82 / $96.82	Facility	26	$96.82	$96.82	$96.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.29 / $471.81 / $868.48	Professional		$239.29	$471.81	$868.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.23 / $102.49 / $174.00	Professional	26	$71.23	$102.49	$174.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $162.19 / $305.77 / $712.39	Professional	TC	$162.19	$305.77	$712.39
United Facility/Professional Professional Modifier Low / Median / High Price $268.11 / $410.05 / $799.45	Professional		$268.11	$410.05	$799.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.80 / $91.31 / $164.36	Professional	26	$72.80	$91.31	$164.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.49 / $291.33 / $583.76	Professional	TC	$190.49	$291.33	$583.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $227.20 / $254.69 / $361.48	Professional		$227.20	$254.69	$361.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $80.47 / $111.00	Professional	26	$69.84	$80.47	$111.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $157.36 / $183.91 / $1,400.00	Professional	TC	$157.36	$183.91	$1,400.00