Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.41 / $31.71 / $49.48	Facility	26	$24.41	$31.71	$49.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.85 / $110.51 / $255.12	Professional		$82.85	$110.51	$255.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.27 / $34.11 / $74.38	Professional	26	$26.27	$34.11	$74.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.01 / $74.27 / $129.40	Professional	TC	$58.01	$74.27	$129.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.65 / $89.65 / $234.08	Professional		$89.65	$89.65	$234.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $51.03 / $70.70	Professional	26	$29.00	$51.03	$70.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.30 / $87.30 / $141.47	Professional		$31.30	$87.30	$141.47
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $117.81 / $153.15 / $218.52	Professional		$117.81	$153.15	$218.52
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.89 / $35.89 / $38.57	Professional	26	$35.89	$35.89	$38.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.57 / $43.57 / $43.57	Facility	26	$43.57	$43.57	$43.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.15 / $123.83 / $230.54	Professional		$90.15	$123.83	$230.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.74 / $40.18 / $74.92	Professional	26	$28.74	$40.18	$74.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.15 / $82.56 / $156.91	Professional	TC	$59.15	$82.56	$156.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $98.17 / $187.34 / $187.34	Facility	26	$98.17	$187.34	$187.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $812.81 / $812.81 / $1,010.33	Professional		$812.81	$812.81	$1,010.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $240.49 / $240.49 / $307.64	Professional	26	$240.49	$240.49	$307.64
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $572.32 / $572.32 / $702.68	Professional	TC	$572.32	$572.32	$702.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $63.94 / $167.20 / $287.06	Professional		$63.94	$167.20	$287.06
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $60.85 / $147.52	Professional	26	$47.94	$60.85	$147.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.29 / $132.36 / $320.88	Professional	TC	$104.29	$132.36	$320.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.07 / $124.73 / $226.69	Professional		$45.07	$124.73	$226.69
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $43.57 / $43.57 / $43.57	Facility	26	$43.57	$43.57	$43.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.46 / $140.65 / $311.33	Professional		$93.46	$140.65	$311.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.74 / $39.54 / $71.52	Professional	26	$28.74	$39.54	$71.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $59.39 / $81.05 / $153.13	Professional	TC	$59.39	$81.05	$153.13
United Facility/Professional Professional Modifier Low / Median / High Price $95.20 / $116.22 / $192.17	Professional		$95.20	$116.22	$192.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $38.54 / $62.25	Professional	26	$31.13	$38.54	$62.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.67 / $78.56 / $126.98	Professional	TC	$64.67	$78.56	$126.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.93 / $112.06 / $159.04	Professional		$99.93	$112.06	$159.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $36.26 / $50.04	Professional	26	$31.48	$36.26	$50.04
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $68.47 / $75.80 / $109.00	Professional	TC	$68.47	$75.80	$109.00