Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $26.92 / $48.98	Facility	26	$25.12	$26.92	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $194.98	Professional		$83.18	$112.20	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $38.02 / $83.18	Professional	26	$23.99	$38.02	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Professional		$91.20	$91.20	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $37.15 / $70.79	Professional	26	$28.84	$37.15	$70.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $93.33 / $125.89	Professional		$29.51	$93.33	$125.89
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $151.36 / $218.78	Professional		$93.33	$151.36	$218.78
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $38.90	Professional	26	$36.31	$36.31	$38.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $61.66	Facility	26	$9.33	$43.65	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $234.42	Professional		$85.11	$117.49	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $35.48 / $72.44	Professional	26	$21.38	$35.48	$72.44
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,000.00 / $1,000.00	Professional		$812.83	$1,000.00	$1,000.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $239.88 / $309.03 / $309.03	Professional	26	$239.88	$309.03	$309.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $26.92 / $48.98	Facility	26	$23.99	$26.92	$48.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $275.42	Professional		$93.33	$134.90	$275.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $83.18	Professional	26	$23.99	$40.74	$83.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $97.72	Professional		$31.62	$33.11	$97.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $123.03 / $251.19	Professional		$39.81	$123.03	$251.19
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $61.66	Facility	26	$9.33	$43.65	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $257.04	Professional		$85.11	$117.49	$257.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $34.67 / $61.66	Professional	26	$20.89	$34.67	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $177.83	Professional		$89.13	$109.65	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $33.11 / $56.23	Professional	26	$21.38	$33.11	$56.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $141.25	Professional		$112.20	$117.49	$141.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $45.71	Professional	26	$36.31	$38.02	$45.71