Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $309.03 / $741.31	Facility		$85.11	$309.03	$741.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $25.70 / $46.77	Facility	26	$20.89	$25.70	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $346.74	Professional		$54.95	$93.33	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $51.29 / $151.36	Professional	26	$25.70	$51.29	$151.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.70 / $173.78 / $645.65	Professional	50	$53.70	$173.78	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $56.23 / $147.91	Professional	TC	$38.90	$56.23	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $79.43 / $125.89	Professional		$63.10	$79.43	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.11 / $60.26	Professional	26	$24.55	$33.11	$60.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $117.49 / $223.87	Professional	50	$85.11	$117.49	$223.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $45.71 / $67.61	Professional	TC	$36.31	$45.71	$67.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $199.53 / $338.84	Facility		$79.43	$199.53	$338.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $64.57 / $87.10	Professional		$26.30	$64.57	$87.10
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $158.49 / $398.11	Facility		$93.33	$158.49	$398.11
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $154.88	Professional		$75.86	$107.15	$154.88
Christus Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $81.28	Facility		$64.57	$64.57	$81.28
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $33.88 / $33.88	Professional	26	$30.20	$33.88	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $204.17 / $363.08	Facility		$77.62	$204.17	$363.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $169.82	Professional		$67.61	$93.33	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $37.15 / $67.61	Professional	26	$26.92	$37.15	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $57.54 / $109.65	Professional	TC	$40.74	$57.54	$109.65
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Facility	26	$204.17	$204.17	$204.17
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $549.54 / $707.95	Professional		$95.50	$549.54	$707.95
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $263.03 / $263.03	Professional	26	$204.17	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $446.68 / $446.68	Professional	TC	$338.84	$446.68	$446.68
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $120.23 / $512.86	Facility		$70.79	$120.23	$512.86
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $25.70 / $41.69	Facility	26	$20.89	$25.70	$41.69
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $104.71 / $275.42	Professional		$58.88	$104.71	$275.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $44.67 / $125.89	Professional	26	$25.70	$44.67	$125.89
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $63.10 / $181.97 / $630.96	Professional	50	$63.10	$181.97	$630.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $63.10 / $125.89	Professional	TC	$39.81	$63.10	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $70.79	Professional		$26.92	$33.11	$70.79
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $616.60 / $691.83	Facility		$173.78	$616.60	$691.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $67.61 / $151.36	Professional		$33.11	$67.61	$151.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $104.71 / $204.17	Facility		$70.79	$104.71	$204.17
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $186.21	Professional		$67.61	$91.20	$186.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $34.67 / $63.10	Professional	26	$26.92	$34.67	$63.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $53.70 / $100.00	Professional	TC	$40.74	$53.70	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $138.04 / $181.97	Facility		$70.79	$138.04	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $93.33 / $141.25	Professional		$72.44	$93.33	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $36.31 / $54.95	Professional	26	$27.54	$36.31	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $57.54 / $87.10	Professional	TC	$43.65	$57.54	$87.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $83.18 / $100.00	Professional		$79.43	$83.18	$100.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $32.36 / $38.02	Professional	26	$30.90	$32.36	$38.02
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $51.29 / $61.66	Professional	TC	$48.98	$51.29	$61.66