Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.22 / $132.00 / $154.85	Facility	26	$83.22	$132.00	$154.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.00 / $496.33 / $938.18	Professional		$343.00	$496.33	$938.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.22 / $135.08 / $320.20	Professional	26	$83.22	$135.08	$320.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.77 / $365.10 / $566.75	Professional	TC	$259.77	$365.10	$566.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $252.34 / $442.39 / $645.16	Professional		$252.34	$442.39	$645.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.61 / $101.54 / $189.18	Professional	26	$77.61	$101.54	$189.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $224.05 / $224.05 / $224.05	Professional	TC	$224.05	$224.05	$224.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.48 / $299.20 / $461.21	Professional		$83.48	$299.20	$461.21
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $378.51 / $450.61 / $720.98	Professional		$378.51	$450.61	$720.98
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $96.04 / $96.04 / $103.05	Professional	26	$96.04	$96.04	$103.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.14 / $561.98 / $1,268.57	Professional		$324.14	$561.98	$1,268.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $121.51 / $212.28	Professional	26	$79.84	$121.51	$212.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $238.42 / $429.36 / $1,041.68	Professional	TC	$238.42	$429.36	$1,041.68
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $745.12 / $935.44 / $953.92	Facility	26	$745.12	$935.44	$953.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,981.06 / $6,160.49 / $6,160.49	Professional		$5,981.06	$6,160.49	$6,160.49
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $883.52 / $883.52 / $883.52	Professional	26	$883.52	$883.52	$883.52
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $5,438.76 / $5,601.93 / $5,601.93	Professional	TC	$5,438.76	$5,601.93	$5,601.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $360.49 / $652.49 / $1,509.92	Professional		$360.49	$652.49	$1,509.92
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.26 / $162.79 / $394.64	Professional	26	$128.26	$162.79	$394.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $362.48 / $460.07 / $1,115.32	Professional	TC	$362.48	$460.07	$1,115.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.03 / $336.36 / $689.76	Professional		$109.03	$336.36	$689.76
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $340.40 / $599.08 / $1,224.60	Professional		$340.40	$599.08	$1,224.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $85.62 / $121.51 / $206.30	Professional	26	$85.62	$121.51	$206.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $246.61 / $410.54 / $984.26	Professional	TC	$246.61	$410.54	$984.26
United Facility/Professional Professional Modifier Low / Median / High Price $389.59 / $550.01 / $1,089.82	Professional		$389.59	$550.01	$1,089.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.61 / $109.71 / $212.60	Professional	26	$87.61	$109.71	$212.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.33 / $418.36 / $839.57	Professional	TC	$296.33	$418.36	$839.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $322.17 / $360.49 / $512.69	Professional		$322.17	$360.49	$512.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $84.20 / $97.01 / $133.81	Professional	26	$84.20	$97.01	$133.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $237.97 / $278.18 / $1,400.00	Professional	TC	$237.97	$278.18	$1,400.00