Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.17 / $77.11 / $124.85	Facility	26	$59.17	$77.11	$124.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.11 / $163.69 / $296.17	Professional		$116.11	$163.69	$296.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.42 / $77.11 / $139.60	Professional	26	$52.42	$77.11	$139.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.80 / $154.56 / $213.00	Professional	26	$75.80	$154.56	$213.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.89 / $139.94 / $202.83	Professional		$76.89	$139.94	$202.83
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $160.09 / $184.10 / $248.00	Professional		$160.09	$184.10	$248.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $88.25 / $91.61 / $93.67	Professional	26	$88.25	$91.61	$93.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.98 / $106.98 / $106.98	Facility	26	$106.98	$106.98	$106.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.75 / $217.09 / $591.02	Professional		$127.75	$217.09	$591.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $83.15 / $161.87	Professional	26	$53.47	$83.15	$161.87
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $221.69 / $453.39 / $453.39	Facility	26	$221.69	$453.39	$453.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,093.52 / $3,186.33 / $3,186.33	Professional		$3,093.52	$3,186.33	$3,186.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $676.01 / $676.01 / $760.80	Professional	26	$676.01	$676.01	$760.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $187.53 / $273.26 / $386.03	Professional		$187.53	$273.26	$386.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.74 / $149.44 / $362.28	Professional	26	$117.74	$149.44	$362.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.40 / $149.66 / $331.82	Professional		$91.40	$149.66	$331.82
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $106.98 / $106.98 / $106.98	Facility	26	$106.98	$106.98	$106.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $233.32 / $506.32	Professional		$135.78	$233.32	$506.32
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $50.64 / $84.02 / $155.72	Professional	26	$50.64	$84.02	$155.72
United Facility/Professional Professional Modifier Low / Median / High Price $139.69 / $197.57 / $381.66	Professional		$139.69	$197.57	$381.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.92 / $84.86 / $140.46	Professional	26	$50.92	$84.86	$140.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.34 / $160.09 / $224.48	Professional		$141.34	$160.09	$224.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $77.30 / $89.18 / $122.58	Professional	26	$77.30	$89.18	$122.58