Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $131.83 / $158.49	Facility	26	$83.18	$131.83	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $501.19 / $1,230.27	Professional		$251.19	$501.19	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $147.91 / $354.81	Professional	26	$85.11	$147.91	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $407.38 / $776.25	Professional	TC	$281.84	$407.38	$776.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $354.81 / $691.83	Professional		$309.03	$354.81	$691.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $190.55	Professional	26	$77.62	$97.72	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $323.59 / $426.58	Professional		$79.43	$323.59	$426.58
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $426.58 / $1,096.48	Professional		$363.08	$426.58	$1,096.48
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $97.72 / $102.33	Professional	26	$95.50	$97.72	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $117.49 / $165.96	Facility	26	$25.12	$117.49	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $575.44 / $1,348.96	Professional		$371.54	$575.44	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $128.82 / $239.88	Professional	26	$85.11	$128.82	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $467.74 / $1,071.52	Professional	TC	$288.40	$467.74	$1,071.52
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $933.25 / $933.25 / $933.25	Facility	26	$933.25	$933.25	$933.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,165.95 / $6,165.95 / $6,165.95	Professional		$6,165.95	$6,165.95	$6,165.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $676.08 / $831.76 / $831.76	Professional	26	$676.08	$831.76	$831.76
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $5,623.41 / $5,623.41 / $5,623.41	Professional	TC	$5,623.41	$5,623.41	$5,623.41
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $131.83 / $158.49	Facility	26	$83.18	$131.83	$158.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $575.44 / $1,258.93	Professional		$363.08	$575.44	$1,258.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $154.88 / $323.59	Professional	26	$97.72	$154.88	$323.59
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $436.52 / $891.25	Professional	TC	$281.84	$436.52	$891.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $380.19 / $891.25	Professional		$104.71	$380.19	$891.25
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $117.49 / $165.96	Facility	26	$25.12	$117.49	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $588.84 / $1,230.27	Professional		$389.05	$588.84	$1,230.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $123.03 / $204.17	Professional	26	$87.10	$123.03	$204.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $436.52 / $1,023.29	Professional	TC	$288.40	$436.52	$1,023.29
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $1,148.15	Professional		$416.87	$588.84	$1,148.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $109.65 / $204.17	Professional	26	$87.10	$109.65	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $457.09 / $912.01	Professional	TC	$323.59	$457.09	$912.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $489.78	Professional		$389.05	$489.78	$489.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $102.33 / $120.23	Professional	26	$97.72	$102.33	$120.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $288.40 / $363.08	Professional	TC	$288.40	$288.40	$363.08