Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.48 / $99.44 / $119.83	Facility	26	$63.48	$99.44	$119.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.64 / $437.17 / $874.64	Professional		$278.64	$437.17	$874.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.48 / $107.53 / $180.15	Professional	26	$63.48	$107.53	$180.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $215.16 / $335.00 / $469.43	Professional	TC	$215.16	$335.00	$469.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.34 / $248.08 / $248.08	Professional		$235.34	$248.08	$248.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.97 / $80.15 / $120.22	Professional	26	$71.97	$80.15	$120.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.27 / $239.88 / $374.92	Professional		$65.27	$239.88	$374.92
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $278.31 / $322.56 / $477.89	Professional		$278.31	$322.56	$477.89
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $72.12 / $72.12 / $78.34	Professional	26	$72.12	$72.12	$78.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.58 / $460.00 / $875.34	Professional		$263.58	$460.00	$875.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.13 / $92.22 / $163.15	Professional	26	$61.13	$92.22	$163.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.36 / $359.32 / $716.26	Professional	TC	$199.36	$359.32	$716.26
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $558.79 / $703.76 / $720.40	Facility	26	$558.79	$703.76	$720.40
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,348.15 / $3,448.60 / $3,448.60	Professional		$3,348.15	$3,448.60	$3,448.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $597.70 / $597.70 / $616.42	Professional	26	$597.70	$597.70	$616.42
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,941.88 / $3,030.13 / $3,030.13	Professional	TC	$2,941.88	$3,030.13	$3,030.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $310.10 / $507.03 / $1,229.16	Professional		$310.10	$507.03	$1,229.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $122.22 / $296.27	Professional	26	$96.29	$122.22	$296.27
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $303.19 / $384.81 / $932.88	Professional	TC	$303.19	$384.81	$932.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $280.39 / $566.66	Professional		$81.96	$280.39	$566.66
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $276.68 / $484.81 / $917.05	Professional		$276.68	$484.81	$917.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $64.42 / $92.22 / $162.00	Professional	26	$64.42	$92.22	$162.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $205.51 / $348.81 / $702.82	Professional	TC	$205.51	$348.81	$702.82
United Facility/Professional Professional Modifier Low / Median / High Price $316.27 / $448.91 / $808.53	Professional		$316.27	$448.91	$808.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.03 / $83.73 / $158.65	Professional	26	$66.03	$83.73	$158.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.10 / $346.02 / $682.89	Professional	TC	$245.10	$346.02	$682.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $262.26 / $293.24 / $417.46	Professional		$262.26	$293.24	$417.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $63.22 / $72.86 / $100.59	Professional	26	$63.22	$72.86	$100.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $199.05 / $232.66 / $1,400.00	Professional	TC	$199.05	$232.66	$1,400.00