Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.73 / $98.21 / $126.07	Facility	26	$78.73	$98.21	$126.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.56 / $388.85 / $889.93	Professional		$304.56	$388.85	$889.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.73 / $99.83 / $225.16	Professional	26	$78.73	$99.83	$225.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.84 / $291.44 / $503.06	Professional	TC	$225.84	$291.44	$503.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $222.65 / $285.83 / $543.73	Professional		$222.65	$285.83	$543.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.54 / $100.27 / $175.59	Professional	26	$70.54	$100.27	$175.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $136.01 / $193.94 / $385.94	Professional	TC	$136.01	$193.94	$385.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $263.13 / $391.14	Professional		$77.70	$263.13	$391.14
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $318.07 / $447.99 / $620.24	Professional		$318.07	$447.99	$620.24
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $89.14 / $95.19 / $227.30	Professional	26	$89.14	$95.19	$227.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.46 / $108.46 / $108.46	Facility	26	$108.46	$108.46	$108.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.00 / $413.75 / $758.45	Professional		$255.00	$413.75	$758.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.00 / $106.64 / $195.75	Professional	26	$72.00	$106.64	$195.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.73 / $309.19 / $584.24	Professional	TC	$182.73	$309.19	$584.24
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $690.96 / $868.88 / $887.84	Facility	26	$690.96	$868.88	$887.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,326.86 / $2,326.86 / $2,876.93	Professional		$2,326.86	$2,326.86	$2,876.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $600.70 / $600.70 / $763.13	Professional	26	$600.70	$600.70	$763.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,909.00 / $2,909.00 / $2,909.00	Professional	TC	$2,909.00	$2,909.00	$2,909.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $159.16 / $499.28 / $1,079.09	Professional		$159.16	$499.28	$1,079.09
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $119.00 / $151.04 / $366.16	Professional	26	$119.00	$151.04	$366.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $313.69 / $398.15 / $965.20	Professional	TC	$313.69	$398.15	$965.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.06 / $290.89 / $555.58	Professional		$102.06	$290.89	$555.58
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $108.46 / $108.46 / $108.46	Facility	26	$108.46	$108.46	$108.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $446.17 / $931.18	Professional		$275.00	$446.17	$931.18
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $76.50 / $100.70 / $188.37	Professional	26	$76.50	$100.70	$188.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $178.97 / $296.41 / $565.29	Professional	TC	$178.97	$296.41	$565.29
United Facility/Professional Professional Modifier Low / Median / High Price $317.50 / $408.10 / $667.12	Professional		$317.50	$408.10	$667.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.99 / $102.49 / $183.05	Professional	26	$81.99	$102.49	$183.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.50 / $304.07 / $513.55	Professional	TC	$227.50	$304.07	$513.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $284.08 / $318.07 / $452.10	Professional		$284.08	$318.07	$452.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $78.13 / $90.05 / $124.23	Professional	26	$78.13	$90.05	$124.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $205.94 / $240.73 / $1,100.00	Professional	TC	$205.94	$240.73	$1,100.00