Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.81 / $76.22 / $121.63	Facility	26	$57.81	$76.22	$121.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.58 / $157.79 / $306.55	Professional		$111.58	$157.79	$306.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.81 / $76.22 / $134.26	Professional	26	$57.81	$76.22	$134.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.85 / $70.67 / $232.83	Professional	TC	$48.85	$70.67	$232.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.38 / $129.38 / $129.38	Professional		$129.38	$129.38	$129.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.82 / $73.84 / $122.05	Professional	26	$60.82	$73.84	$122.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.42 / $133.46 / $193.15	Professional		$74.42	$133.46	$193.15
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $157.33 / $228.44 / $260.37	Professional		$157.33	$228.44	$260.37
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $85.99 / $87.31 / $92.03	Professional	26	$85.99	$87.31	$92.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.05 / $228.43 / $601.77	Professional		$132.05	$228.43	$601.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $88.36 / $173.76	Professional	26	$59.82	$88.36	$173.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.16 / $122.74 / $427.42	Professional	TC	$59.16	$122.74	$427.42
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $213.91 / $438.57 / $438.57	Facility	26	$213.91	$438.57	$438.57
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,140.08 / $3,234.28 / $3,234.28	Professional		$3,140.08	$3,234.28	$3,234.28
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $681.88 / $681.88 / $748.95	Professional	26	$681.88	$681.88	$748.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,808.09 / $2,892.33 / $2,892.33	Professional	TC	$2,808.09	$2,892.33	$2,892.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $159.86 / $236.30 / $371.58	Professional		$159.86	$236.30	$371.58
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.80 / $145.71 / $353.24	Professional	26	$114.80	$145.71	$353.24
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.99 / $114.21 / $276.88	Professional	TC	$89.99	$114.21	$276.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $130.47 / $306.11	Professional		$57.55	$130.47	$306.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.46 / $237.67 / $501.42	Professional		$137.46	$237.67	$501.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.58 / $87.88 / $165.22	Professional	26	$56.58	$87.88	$165.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $59.24 / $114.99 / $373.52	Professional	TC	$59.24	$114.99	$373.52
United Facility/Professional Professional Modifier Low / Median / High Price $151.54 / $202.45 / $415.88	Professional		$151.54	$202.45	$415.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.11 / $92.91 / $147.59	Professional	26	$61.11	$92.91	$147.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.62 / $111.82 / $347.53	Professional	TC	$70.62	$111.82	$347.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $152.29 / $213.19	Professional		$134.44	$152.29	$213.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $75.37 / $86.88 / $119.21	Professional	26	$75.37	$86.88	$119.21
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $59.08 / $65.41 / $93.99	Professional	TC	$59.08	$65.41	$93.99