Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $40.74 / $70.79	Facility	26	$30.90	$40.74	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $190.55	Professional		$79.43	$109.65	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $45.71 / $95.50	Professional	26	$31.62	$45.71	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $177.83	Professional		$58.88	$75.86	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $46.77 / $75.86	Professional	26	$35.48	$46.77	$75.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $83.18 / $117.49	Professional		$37.15	$83.18	$117.49
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $114.82 / $138.04	Professional		$89.13	$114.82	$138.04
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $47.86	Professional	26	$44.67	$44.67	$47.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $234.42	Professional		$83.18	$120.23	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.67 / $91.20	Professional	26	$30.20	$44.67	$91.20
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	26	$309.03	$309.03	$309.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $891.25 / $891.25	Professional		$794.33	$891.25	$891.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $389.05 / $389.05	Professional	26	$309.03	$389.05	$389.05
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $34.67 / $70.79	Facility	26	$30.90	$34.67	$70.79
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $251.19	Professional		$85.11	$125.89	$251.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $104.71	Professional	26	$32.36	$50.12	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $87.10	Professional		$32.36	$33.11	$87.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $120.23 / $295.12	Professional		$53.70	$120.23	$295.12
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $251.19	Professional		$87.10	$117.49	$251.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.66 / $79.43	Professional	26	$29.51	$42.66	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $181.97	Professional		$89.13	$109.65	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $34.67 / $58.88	Professional	26	$29.51	$34.67	$58.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $128.82	Professional		$102.33	$107.15	$128.82
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $48.98 / $58.88	Professional	26	$46.77	$48.98	$58.88