Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.69 / $140.71 / $167.36	Facility	26	$88.69	$140.71	$167.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.57 / $475.00 / $800.43	Professional		$280.57	$475.00	$800.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.69 / $140.71 / $344.64	Professional	26	$88.69	$140.71	$344.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.88 / $316.56 / $480.00	Professional	TC	$191.88	$316.56	$480.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.10 / $314.89 / $537.01	Professional		$121.10	$314.89	$537.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.74 / $127.20 / $201.58	Professional	26	$85.74	$127.20	$201.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $206.52 / $206.52 / $206.52	Professional	TC	$206.52	$206.52	$206.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.97 / $261.04 / $389.89	Professional		$88.97	$261.04	$389.89
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $301.74 / $475.32 / $758.09	Professional		$301.74	$475.32	$758.09
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $108.12 / $181.86	Professional	26	$102.33	$108.12	$181.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.08 / $500.00 / $1,267.63	Professional		$271.08	$500.00	$1,267.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.10 / $138.00 / $241.93	Professional	26	$85.10	$138.00	$241.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.31 / $348.07 / $994.34	Professional	TC	$179.31	$348.07	$994.34
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $794.00 / $996.56 / $1,016.96	Facility	26	$794.00	$996.56	$1,016.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,199.75 / $6,385.74 / $6,385.74	Professional		$6,199.75	$6,385.74	$6,385.74
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $931.20 / $931.20 / $931.20	Professional	26	$931.20	$931.20	$931.20
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $5,551.18 / $5,717.71 / $5,717.71	Professional	TC	$5,551.18	$5,717.71	$5,717.71
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $191.08 / $472.58 / $1,260.20	Professional		$191.08	$472.58	$1,260.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $136.66 / $173.46 / $420.52	Professional	26	$136.66	$173.46	$420.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.91 / $346.38 / $839.72	Professional	TC	$272.91	$346.38	$839.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.17 / $253.18 / $528.04	Professional		$116.17	$253.18	$528.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $283.14 / $555.82 / $1,137.46	Professional		$283.14	$555.82	$1,137.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $91.55 / $138.00 / $235.53	Professional	26	$91.55	$138.00	$235.53
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $184.68 / $342.36 / $918.80	Professional	TC	$184.68	$342.36	$918.80
United Facility/Professional Professional Modifier Low / Median / High Price $317.50 / $485.59 / $986.42	Professional		$317.50	$485.59	$986.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.18 / $117.29 / $224.92	Professional	26	$97.18	$117.29	$224.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.80 / $318.23 / $715.39	Professional	TC	$217.80	$318.23	$715.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $268.89 / $301.74 / $427.79	Professional		$268.89	$301.74	$427.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $89.73 / $103.37 / $142.57	Professional	26	$89.73	$103.37	$142.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $179.17 / $209.42 / $1,400.00	Professional	TC	$179.17	$209.42	$1,400.00