Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $18.20 / $31.62	Facility	26	$15.49	$18.20	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $77.62 / $213.80	Professional		$52.48	$77.62	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $28.84 / $75.86	Professional	26	$16.60	$28.84	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $141.25	Professional		$66.07	$66.07	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $23.99 / $33.88	Professional	26	$18.62	$23.99	$33.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $60.26 / $83.18	Professional		$19.05	$60.26	$83.18
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $125.89 / $125.89	Professional		$63.10	$125.89	$125.89
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $25.12 / $25.12	Professional	26	$22.91	$25.12	$25.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $112.20 / $218.78	Professional		$64.57	$112.20	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $23.99 / $51.29	Professional	26	$15.85	$23.99	$51.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $194.98 / $194.98	Professional	26	$154.88	$194.98	$194.98
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $18.20 / $31.62	Facility	26	$15.14	$18.20	$31.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.33 / $229.09	Professional		$57.54	$102.33	$229.09
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $28.84 / $61.66	Professional	26	$16.60	$28.84	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $33.11 / $63.10	Professional		$20.42	$33.11	$63.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $75.86 / $177.83	Professional		$25.70	$75.86	$177.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $112.20 / $204.17	Professional		$64.57	$112.20	$204.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $23.44 / $40.74	Professional	26	$15.49	$23.44	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $346.74	Professional		$67.61	$114.82	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $23.44 / $37.15	Professional	26	$16.60	$23.44	$37.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $81.28 / $97.72	Professional		$77.62	$81.28	$97.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $25.12 / $30.20	Professional	26	$23.99	$25.12	$30.20