Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.69 / $140.72 / $167.36	Facility	26	$88.69	$140.72	$167.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.85 / $475.00 / $794.21	Professional		$280.85	$475.00	$794.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.69 / $140.72 / $358.34	Professional	26	$88.69	$140.72	$358.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.16 / $309.07 / $462.42	Professional	TC	$192.16	$309.07	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $211.65 / $302.36 / $538.11	Professional		$211.65	$302.36	$538.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.70 / $127.20 / $201.58	Professional	26	$82.70	$127.20	$201.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $222.52 / $222.52 / $222.52	Professional	TC	$222.52	$222.52	$222.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.66 / $258.75 / $402.98	Professional		$90.66	$258.75	$402.98
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $302.36 / $480.00 / $755.90	Professional		$302.36	$480.00	$755.90
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $108.12 / $171.25	Professional	26	$102.33	$108.12	$171.25
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 $271.02 / $500.20 / $1,267.63	Professional		$271.02	$500.20	$1,267.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.66 / $131.57 / $236.70	Professional	26	$82.66	$131.57	$236.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.86 / $349.14 / $994.34	Professional	TC	$179.86	$349.14	$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 $6,195.24 / $6,381.10 / $6,381.10	Professional		$6,195.24	$6,381.10	$6,381.10
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 $197.26 / $520.91 / $1,262.80	Professional		$197.26	$520.91	$1,262.80
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 $273.75 / $347.46 / $842.32	Professional	TC	$273.75	$347.46	$842.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.17 / $253.96 / $529.13	Professional		$116.17	$253.96	$529.13
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 $281.50 / $571.69 / $1,142.32	Professional		$281.50	$571.69	$1,142.32
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $89.99 / $124.97 / $235.53	Professional	26	$89.99	$124.97	$235.53
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $179.86 / $346.84 / $954.01	Professional	TC	$179.86	$346.84	$954.01
United Facility/Professional Professional Modifier Low / Median / High Price $299.39 / $470.69 / $945.53	Professional		$299.39	$470.69	$945.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.85 / $117.29 / $224.35	Professional	26	$98.85	$117.29	$224.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.39 / $308.35 / $695.33	Professional	TC	$217.39	$308.35	$695.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.44 / $302.36 / $428.68	Professional		$269.44	$302.36	$428.68
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 $179.72 / $210.06 / $1,400.00	Professional	TC	$179.72	$210.06	$1,400.00