Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.18 / $134.91 / $158.47	Facility	26	$85.18	$134.91	$158.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.55 / $475.00 / $1,079.92	Professional		$297.55	$475.00	$1,079.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.18 / $140.00 / $335.95	Professional	26	$85.18	$140.00	$335.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $212.37 / $335.00 / $565.00	Professional	TC	$212.37	$335.00	$565.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.81 / $308.14 / $565.21	Professional		$221.81	$308.14	$565.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.15 / $108.83 / $192.93	Professional	26	$79.15	$108.83	$192.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $152.55 / $152.55 / $464.24	Professional	TC	$152.55	$152.55	$464.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.13 / $262.63 / $403.48	Professional		$85.13	$262.63	$403.48
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $316.54 / $435.00 / $633.74	Professional		$316.54	$435.00	$633.74
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $97.94 / $103.75 / $202.10	Professional	26	$97.94	$103.75	$202.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.73 / $528.34 / $1,290.45	Professional		$284.73	$528.34	$1,290.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.24 / $127.05 / $219.45	Professional	26	$83.24	$127.05	$219.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.20 / $385.00 / $1,041.66	Professional	TC	$197.20	$385.00	$1,041.66
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $759.68 / $954.08 / $973.04	Facility	26	$759.68	$954.08	$973.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,025.38 / $6,206.15 / $6,206.15	Professional		$6,025.38	$6,206.15	$6,206.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $891.52 / $891.52 / $891.52	Professional	26	$891.52	$891.52	$891.52
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $5,457.89 / $5,621.63 / $5,621.63	Professional	TC	$5,457.89	$5,621.63	$5,621.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $183.98 / $544.00 / $1,425.00	Professional		$183.98	$544.00	$1,425.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $130.78 / $165.99 / $402.40	Professional	26	$130.78	$165.99	$402.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $299.82 / $380.54 / $922.52	Professional	TC	$299.82	$380.54	$922.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $113.59 / $289.64 / $634.79	Professional		$113.59	$289.64	$634.79
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $118.86	Facility	26	$118.86	$118.86	$118.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $308.30 / $586.71 / $1,115.67	Professional		$308.30	$586.71	$1,115.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.46 / $127.77 / $215.17	Professional	26	$87.46	$127.77	$215.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $206.94 / $369.97 / $983.94	Professional	TC	$206.94	$369.97	$983.94
United Facility/Professional Professional Modifier Low / Median / High Price $337.13 / $523.01 / $1,070.86	Professional		$337.13	$523.01	$1,070.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.51 / $111.88 / $211.99	Professional	26	$89.51	$111.88	$211.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.03 / $393.49 / $756.66	Professional	TC	$242.03	$393.49	$756.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $282.69 / $316.87 / $449.82	Professional		$282.69	$316.87	$449.82
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $85.86 / $98.94 / $136.46	Professional	26	$85.86	$98.94	$136.46
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $196.84 / $230.08 / $1,400.00	Professional	TC	$196.84	$230.08	$1,400.00