Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.17 / $38.31 / $60.68	Facility	26	$29.17	$38.31	$60.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $92.62 / $185.98	Professional		$67.27	$92.62	$185.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.71 / $37.93 / $65.81	Professional	26	$16.71	$37.93	$65.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.68 / $51.60 / $168.56	Professional	TC	$35.68	$51.60	$168.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.27 / $68.27 / $68.27	Professional		$68.27	$68.27	$68.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $43.34 / $69.00	Professional	26	$34.67	$43.34	$69.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $79.38 / $113.40	Professional		$37.61	$79.38	$113.40
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $111.40 / $152.18	Professional		$65.00	$111.40	$152.18
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $45.73 / $48.12	Professional	26	$42.89	$45.73	$48.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.72 / $52.72 / $52.72	Facility	26	$52.72	$52.72	$52.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.54 / $127.78 / $440.79	Professional		$74.54	$127.78	$440.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $36.65 / $74.91	Professional	26	$16.84	$36.65	$74.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.48 / $81.05 / $382.52	Professional	TC	$41.48	$81.05	$382.52
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $108.25 / $220.50 / $220.50	Facility	26	$108.25	$220.50	$220.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,899.89 / $2,986.89 / $2,986.89	Professional		$2,899.89	$2,986.89	$2,986.89
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $425.60 / $425.60 / $425.60	Professional	26	$425.60	$425.60	$425.60
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 $89.50 / $153.16 / $269.75	Professional		$89.50	$153.16	$269.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.19 / $72.58 / $175.96	Professional	26	$57.19	$72.58	$175.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.49 / $80.59 / $195.36	Professional	TC	$63.49	$80.59	$195.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.05 / $85.96 / $190.52	Professional		$54.05	$85.96	$190.52
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $52.72 / $52.72 / $52.72	Facility	26	$52.72	$52.72	$52.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.48 / $136.15 / $299.00	Professional		$76.48	$136.15	$299.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.99 / $38.57 / $74.31	Professional	26	$15.99	$38.57	$74.31
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.75 / $77.31 / $266.77	Professional	TC	$41.75	$77.31	$266.77
United Facility/Professional Professional Modifier Low / Median / High Price $79.91 / $120.72 / $326.32	Professional		$79.91	$120.72	$326.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.46 / $35.74 / $65.56	Professional	26	$16.46	$35.74	$65.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.92 / $71.89 / $308.51	Professional	TC	$50.92	$71.89	$308.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $89.50 / $125.93	Professional		$79.23	$89.50	$125.93
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $43.34 / $59.59	Professional	26	$37.54	$43.34	$59.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.68 / $46.15 / $66.34	Professional	TC	$41.68	$46.15	$66.34