Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $42.66 / $77.62	Facility	26	$35.48	$42.66	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $275.42	Professional		$83.18	$117.49	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $190.55	Professional		$75.86	$87.10	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $93.33 / $131.83	Professional		$45.71	$93.33	$131.83
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $208.93	Professional		$169.82	$169.82	$208.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $61.66 / $87.10	Facility	26	$13.18	$61.66	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $165.96 / $575.44	Professional		$95.50	$165.96	$575.44
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $323.59 / $323.59	Facility	26	$323.59	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $42.66 / $77.62	Facility	26	$32.36	$42.66	$77.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $147.91 / $309.03	Professional		$87.10	$147.91	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $91.20	Professional		$32.36	$33.11	$91.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $112.20 / $302.00	Professional		$56.23	$112.20	$302.00
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $61.66 / $87.10	Facility	26	$13.18	$61.66	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $169.82 / $416.87	Professional		$97.72	$169.82	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $151.36 / $363.08	Professional		$109.65	$151.36	$363.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $114.82 / $134.90	Professional		$109.65	$114.82	$134.90