Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.42 / $518.01 / $961.20	Facility		$89.42	$518.01	$961.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $12.65 / $19.98	Facility	26	$9.77	$12.65	$19.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.54 / $91.36 / $160.35	Professional		$70.54	$91.36	$160.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $14.45 / $27.38	Professional	26	$10.68	$14.45	$27.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.99 / $76.68 / $132.75	Professional	TC	$59.99	$76.68	$132.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.45 / $65.45 / $65.45	Professional		$65.45	$65.45	$65.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $24.16 / $35.15	Professional	26	$11.72	$24.16	$35.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.25 / $589.59 / $1,006.73	Facility		$246.25	$589.59	$1,006.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.01 / $72.61 / $113.60	Professional		$16.01	$72.61	$113.60
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $149.62 / $423.01 / $1,115.60	Facility		$149.62	$423.01	$1,115.60
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $116.88 / $158.94	Professional		$72.00	$116.88	$158.94
Christus Facility/Professional Facility Modifier Low / Median / High Price $93.36 / $101.17 / $153.88	Facility		$93.36	$101.17	$153.88
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $14.50 / $16.07	Professional	26	$14.50	$14.50	$16.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.30 / $353.04 / $819.29	Facility		$149.30	$353.04	$819.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.16 / $98.33 / $188.12	Professional		$72.16	$98.33	$188.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $18.19 / $33.03	Professional	26	$12.75	$18.19	$33.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.10 / $81.94 / $157.63	Professional	TC	$59.10	$81.94	$157.63
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $216.57 / $548.44 / $548.44	Facility		$216.57	$548.44	$548.44
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $53.99 / $100.00 / $100.00	Facility	26	$53.99	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $687.89 / $687.89 / $854.25	Professional		$687.89	$687.89	$854.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	26	$150.00	$150.00	$150.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $591.79 / $591.79 / $731.03	Professional	TC	$591.79	$591.79	$731.03
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $82.18 / $103.95 / $188.12	Facility		$82.18	$103.95	$188.12
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $147.50 / $242.13	Professional		$38.15	$147.50	$242.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.34 / $24.55 / $59.52	Professional	26	$19.34	$24.55	$59.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $108.49 / $137.69 / $333.80	Professional	TC	$108.49	$137.69	$333.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $110.69 / $191.74	Professional		$18.73	$110.69	$191.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $105.93 / $244.47	Facility		$83.23	$105.93	$244.47
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.61 / $113.00 / $252.00	Professional		$72.61	$113.00	$252.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.90 / $17.25 / $32.06	Professional	26	$12.90	$17.25	$32.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $58.24 / $81.94 / $150.90	Professional	TC	$58.24	$81.94	$150.90
United Facility/Professional Facility Modifier Low / Median / High Price $132.53 / $185.98 / $483.44	Facility		$132.53	$185.98	$483.44
United Facility/Professional Professional Modifier Low / Median / High Price $74.17 / $93.95 / $155.34	Professional		$74.17	$93.95	$155.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.46 / $16.30 / $27.07	Professional	26	$13.46	$16.30	$27.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.72 / $78.18 / $123.44	Professional	TC	$61.72	$78.18	$123.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.92 / $93.50 / $133.62	Professional		$83.92	$93.50	$133.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.70 / $14.64 / $20.22	Professional	26	$12.70	$14.64	$20.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.22 / $78.86 / $113.40	Professional	TC	$71.22	$78.86	$113.40