Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $109.65 / $144.54	Facility	26	$75.86	$109.65	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $457.09 / $870.96	Professional		$316.23	$457.09	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $218.78	Professional	26	$70.79	$112.20	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $338.84 / $562.34	Professional	TC	$234.42	$338.84	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $100.00 / $158.49	Professional	26	$70.79	$100.00	$158.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $281.84 / $389.05	Professional		$75.86	$281.84	$389.05
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $295.12 / $512.86	Professional		$269.15	$295.12	$512.86
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $81.28 / $85.11	Professional	26	$79.43	$81.28	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $489.78 / $977.24	Professional		$302.00	$489.78	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $107.15 / $204.17	Professional	26	$72.44	$107.15	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $380.19 / $758.58	Professional	TC	$234.42	$380.19	$758.58
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Professional		$3,019.95	$3,019.95	$3,019.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Professional	26	$851.14	$851.14	$851.14
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,570.40 / $2,570.40 / $2,630.27	Professional	TC	$2,570.40	$2,570.40	$2,630.27
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $109.65 / $144.54	Facility	26	$69.18	$109.65	$144.54
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $501.19 / $1,071.52	Professional		$338.84	$501.19	$1,071.52
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $123.03 / $239.88	Professional	26	$81.28	$123.03	$239.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $354.81 / $645.65	Professional	TC	$245.47	$354.81	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $275.42	Professional		$32.36	$33.11	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $323.59 / $954.99	Professional		$87.10	$323.59	$954.99
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $891.25	Professional		$309.03	$501.19	$891.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $173.78	Professional	26	$72.44	$104.71	$173.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $354.81 / $676.08	Professional	TC	$234.42	$354.81	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $457.09 / $794.33	Professional		$331.13	$457.09	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $91.20 / $158.49	Professional	26	$74.13	$91.20	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $363.08 / $645.65	Professional	TC	$257.04	$363.08	$645.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $398.11	Professional		$323.59	$338.84	$398.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $85.11 / $100.00	Professional	26	$81.28	$85.11	$100.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $239.88 / $302.00	Professional	TC	$239.88	$239.88	$302.00