Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.23 / $87.73 / $112.73	Facility	26	$70.23	$87.73	$112.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.09 / $302.31 / $618.48	Professional		$225.09	$302.31	$618.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.23 / $87.73 / $164.50	Professional	26	$70.23	$87.73	$164.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $195.87 / $315.44 / $315.44	Professional		$195.87	$315.44	$315.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.42 / $113.45 / $157.01	Professional	26	$64.42	$113.45	$157.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.44 / $193.64 / $315.26	Professional		$70.44	$193.64	$315.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $273.49 / $356.00 / $559.62	Professional		$273.49	$356.00	$559.62
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $77.40 / $79.70 / $84.63	Professional	26	$77.40	$79.70	$84.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.68 / $389.30 / $718.47	Professional		$251.68	$389.30	$718.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $95.49 / $174.29	Professional	26	$65.80	$95.49	$174.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $618.08 / $776.08 / $792.40	Facility	26	$618.08	$776.08	$792.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,854.54 / $2,940.17 / $2,940.17	Professional		$2,854.54	$2,940.17	$2,940.17
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $536.20 / $536.20 / $683.18	Professional	26	$536.20	$536.20	$683.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $365.93 / $450.02 / $710.40	Professional		$365.93	$450.02	$710.40
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
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.66 / $273.05 / $534.41	Professional		$95.66	$273.05	$534.41
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $414.55 / $825.92	Professional		$255.00	$414.55	$825.92
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.19 / $90.26 / $168.41	Professional	26	$71.19	$90.26	$168.41
United Facility/Professional Professional Modifier Low / Median / High Price $283.05 / $367.82 / $655.29	Professional		$283.05	$367.82	$655.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.34 / $91.67 / $163.72	Professional	26	$73.34	$91.67	$163.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $221.68 / $248.63 / $352.69	Professional		$221.68	$248.63	$352.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $80.52 / $111.00	Professional	26	$69.84	$80.52	$111.00