Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.27 / $82.48 / $98.62	Facility	26	$52.27	$82.48	$98.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.57 / $380.29 / $969.71	Professional		$217.57	$380.29	$969.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.52 / $101.14 / $254.90	Professional	26	$59.52	$101.14	$254.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $712.50 / $712.50 / $712.50	Professional	50	$712.50	$712.50	$712.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.05 / $259.35 / $480.00	Professional	TC	$158.05	$259.35	$480.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.52 / $177.92 / $374.07	Professional		$146.52	$177.92	$374.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.37 / $61.81 / $117.89	Professional	26	$48.37	$61.81	$117.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $119.09 / $119.09 / $191.89	Professional	TC	$119.09	$119.09	$191.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $172.79 / $271.75	Professional		$52.45	$172.79	$271.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $209.31 / $296.00 / $495.00	Professional		$209.31	$296.00	$495.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $59.85 / $59.85 / $64.45	Professional	26	$59.85	$59.85	$64.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.40 / $375.00 / $751.32	Professional		$190.40	$375.00	$751.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.17 / $75.83 / $138.69	Professional	26	$50.17	$75.83	$138.69
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.09 / $338.09 / $410.88	Professional	50	$338.09	$338.09	$410.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.69 / $284.92 / $634.53	Professional	TC	$134.69	$284.92	$634.53
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $463.68 / $583.84 / $596.96	Facility	26	$463.68	$583.84	$596.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,789.74 / $2,873.43 / $2,873.43	Professional		$2,789.74	$2,873.43	$2,873.43
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $531.65 / $531.65 / $531.65	Professional	26	$531.65	$531.65	$531.65
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,459.04 / $2,524.69 / $2,526.42	Professional	TC	$2,459.04	$2,524.69	$2,526.42
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $101.83 / $332.29 / $875.96	Professional		$101.83	$332.29	$875.96
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.90 / $101.41 / $245.84	Professional	26	$79.90	$101.41	$245.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.79 / $259.92 / $630.12	Professional	TC	$204.79	$259.92	$630.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.17 / $190.15 / $401.42	Professional		$68.17	$190.15	$401.42
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $209.31 / $407.02 / $740.13	Professional		$209.31	$407.02	$740.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $76.39 / $138.69	Professional	26	$53.47	$76.39	$138.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $141.55 / $275.82 / $630.00	Professional	TC	$141.55	$275.82	$630.00
United Facility/Professional Professional Modifier Low / Median / High Price $222.40 / $366.31 / $664.01	Professional		$222.40	$366.31	$664.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $68.93 / $130.61	Professional	26	$54.76	$68.93	$130.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.81 / $289.08 / $497.95	Professional	TC	$163.81	$289.08	$497.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $186.90 / $209.31 / $297.49	Professional		$186.90	$209.31	$297.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.45 / $60.46 / $83.44	Professional	26	$52.45	$60.46	$83.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $134.44 / $157.15 / $1,400.00	Professional	TC	$134.44	$157.15	$1,400.00