Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.73 / $19.10 / $30.31	Facility	26	$14.73	$19.10	$30.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.58 / $114.97 / $165.93	Professional		$90.58	$114.97	$165.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $20.56 / $31.34	Professional	26	$15.38	$20.56	$31.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $18.39 / $23.82	Professional	26	$17.32	$18.39	$23.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.03 / $94.51 / $150.06	Professional		$21.03	$94.51	$150.06
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $97.00 / $195.54	Professional		$97.00	$97.00	$195.54
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.43 / $21.43 / $23.29	Professional	26	$21.43	$21.43	$23.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $26.63 / $26.63	Facility	26	$26.63	$26.63	$26.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.94 / $124.94 / $245.69	Professional		$90.94	$124.94	$245.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.11 / $26.82 / $48.64	Professional	26	$19.11	$26.82	$48.64
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $68.72 / $111.77 / $111.77	Facility	26	$68.72	$111.77	$111.77
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $893.01 / $893.01 / $1,115.78	Professional		$893.01	$893.01	$1,115.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $188.00 / $188.00 / $188.00	Professional	26	$188.00	$188.00	$188.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $160.53 / $211.89 / $439.94	Professional		$160.53	$211.89	$439.94
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $36.29 / $88.00	Professional	26	$28.60	$36.29	$88.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.23 / $136.41 / $241.27	Professional		$27.23	$136.41	$241.27
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $26.63 / $26.63	Facility	26	$26.63	$26.63	$26.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $94.46 / $142.82 / $328.00	Professional		$94.46	$142.82	$328.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.12 / $25.82 / $46.47	Professional	26	$19.12	$25.82	$46.47
United Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $123.42 / $203.17	Professional		$97.44	$123.42	$203.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $23.83 / $40.85	Professional	26	$19.98	$23.83	$40.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.60 / $122.21 / $174.43	Professional		$109.60	$122.21	$174.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $21.65 / $29.88	Professional	26	$18.78	$21.65	$29.88