Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.08 / $90.52 / $122.85	Facility	26	$69.08	$90.52	$122.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $315.73 / $464.23 / $725.00	Professional		$315.73	$464.23	$725.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $118.31 / $197.62	Professional	26	$69.08	$118.31	$197.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.68 / $335.00 / $494.53	Professional	TC	$226.68	$335.00	$494.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.16 / $64.16 / $113.01	Professional	26	$64.16	$64.16	$113.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $260.24 / $403.47	Professional		$73.42	$260.24	$403.47
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $300.17 / $348.12 / $392.00	Professional		$300.17	$348.12	$392.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $79.38 / $79.38 / $85.63	Professional	26	$79.38	$79.38	$85.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.77 / $490.52 / $875.51	Professional		$284.77	$490.52	$875.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.93 / $101.83 / $181.93	Professional	26	$65.93	$101.83	$181.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.62 / $375.39 / $718.02	Professional	TC	$213.62	$375.39	$718.02
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $615.67 / $772.96 / $789.92	Facility	26	$615.67	$772.96	$789.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,007.15 / $3,039.70 / $3,039.70	Professional		$3,007.15	$3,039.70	$3,039.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $848.54 / $848.54 / $848.54	Professional	26	$848.54	$848.54	$848.54
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,544.17 / $2,573.94 / $2,613.88	Professional	TC	$2,544.17	$2,573.94	$2,613.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $403.65 / $547.05 / $915.75	Professional		$403.65	$547.05	$915.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $105.96 / $134.49 / $326.04	Professional	26	$105.96	$134.49	$326.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $325.05 / $412.57 / $1,000.16	Professional	TC	$325.05	$412.57	$1,000.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $90.42 / $301.52 / $608.63	Professional		$90.42	$301.52	$608.63
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $297.07 / $514.13 / $967.50	Professional		$297.07	$514.13	$967.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.09 / $101.85 / $176.41	Professional	26	$71.09	$101.85	$176.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $218.24 / $363.38 / $700.11	Professional	TC	$218.24	$363.38	$700.11
United Facility/Professional Professional Modifier Low / Median / High Price $334.68 / $469.62 / $804.20	Professional		$334.68	$469.62	$804.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.05 / $91.31 / $155.22	Professional	26	$73.05	$91.31	$155.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $241.94 / $362.57 / $661.20	Professional	TC	$241.94	$362.57	$661.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $282.97 / $316.47 / $450.25	Professional		$282.97	$316.47	$450.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.56 / $80.20 / $110.57	Professional	26	$69.56	$80.20	$110.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $213.40 / $249.41 / $1,400.00	Professional	TC	$213.40	$249.41	$1,400.00