Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.91 / $77.53 / $119.02	Facility	26	$58.91	$77.53	$119.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.32 / $149.84 / $281.37	Professional		$108.32	$149.84	$281.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.34 / $81.34 / $136.29	Professional	26	$64.34	$81.34	$136.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.71 / $70.52 / $114.61	Professional	26	$61.71	$70.52	$114.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $130.93 / $214.44	Professional		$75.79	$130.93	$214.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $151.72 / $151.72 / $247.00	Professional		$151.72	$151.72	$247.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $87.25 / $93.34 / $94.51	Professional	26	$87.25	$93.34	$94.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.81 / $106.81 / $106.81	Facility	26	$106.81	$106.81	$106.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.71 / $217.66 / $625.79	Professional		$128.71	$217.66	$625.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $101.08 / $184.05	Professional	26	$71.81	$101.08	$184.05
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $217.15 / $445.22 / $445.22	Facility	26	$217.15	$445.22	$445.22
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,391.09 / $3,492.82 / $3,492.82	Professional		$3,391.09	$3,492.82	$3,492.82
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $632.75 / $632.75 / $759.53	Professional	26	$632.75	$632.75	$759.53
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $177.57 / $249.78 / $360.16	Professional		$177.57	$249.78	$360.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $116.48 / $147.84 / $358.40	Professional	26	$116.48	$147.84	$358.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.78 / $108.53 / $322.42	Professional		$41.78	$108.53	$322.42
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $106.81 / $106.81 / $106.81	Facility	26	$106.81	$106.81	$106.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $132.22 / $241.85 / $519.12	Professional		$132.22	$241.85	$519.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $71.81 / $99.56 / $177.05	Professional	26	$71.81	$99.56	$177.05
United Facility/Professional Professional Modifier Low / Median / High Price $143.53 / $190.95 / $422.21	Professional		$143.53	$190.95	$422.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.55 / $94.97 / $155.11	Professional	26	$77.55	$94.97	$155.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.19 / $146.53 / $204.84	Professional		$129.19	$146.53	$204.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $76.47 / $88.16 / $120.96	Professional	26	$76.47	$88.16	$120.96