Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $83.18 / $97.72	Facility	26	$52.48	$83.18	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $389.05 / $1,230.27	Professional		$162.18	$389.05	$1,230.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $112.20 / $354.81	Professional	26	$61.66	$112.20	$354.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $131.83 / $707.95 / $1,096.48	Professional	50	$131.83	$707.95	$1,096.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $275.42 / $562.34	Professional	TC	$162.18	$275.42	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $181.97 / $302.00	Professional		$147.91	$181.97	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $107.15	Professional	26	$47.86	$61.66	$107.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $125.89 / $269.15	Professional	TC	$104.71	$125.89	$269.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $173.78 / $234.42	Professional		$48.98	$173.78	$234.42
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $302.00 / $676.08	Professional		$208.93	$302.00	$676.08
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $64.57	Professional	26	$60.26	$60.26	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $72.44 / $104.71	Facility	26	$15.49	$72.44	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $398.11 / $776.25	Professional		$213.80	$398.11	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $79.43 / $151.36	Professional	26	$53.70	$79.43	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $309.03 / $630.96	Professional	TC	$154.88	$309.03	$630.96
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $588.84 / $588.84 / $588.84	Facility	26	$588.84	$588.84	$588.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Professional		$2,884.03	$2,884.03	$2,884.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	26	$537.03	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Professional	TC	$2,511.89	$2,511.89	$2,511.89
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $69.18 / $109.65	Facility	26	$52.48	$69.18	$109.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $426.58 / $977.24	Professional		$218.78	$426.58	$977.24
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $112.20 / $263.03	Professional	26	$63.10	$112.20	$263.03
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $229.09 / $707.95 / $1,096.48	Professional	50	$229.09	$707.95	$1,096.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $281.84 / $588.84	Professional	TC	$165.96	$281.84	$588.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $213.80 / $691.83	Professional		$64.57	$213.80	$691.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $72.44 / $104.71	Facility	26	$15.49	$72.44	$104.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $398.11 / $741.31	Professional		$213.80	$398.11	$741.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $134.90	Professional	26	$53.70	$77.62	$134.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $281.84 / $616.60	Professional	TC	$154.88	$281.84	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $363.08 / $645.65	Professional		$223.87	$363.08	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $128.82	Professional	26	$54.95	$69.18	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $295.12 / $501.19	Professional	TC	$162.18	$295.12	$501.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $263.03	Professional		$213.80	$213.80	$263.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $63.10 / $75.86	Professional	26	$60.26	$63.10	$75.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	TC	$190.55	$190.55	$190.55