Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.34 / $459.29 / $1,158.33	Facility		$98.34	$459.29	$1,158.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.03 / $23.37 / $38.97	Facility	26	$18.03	$23.37	$38.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $50.60 / $278.97 / $565.36	Facility	TC	$50.60	$278.97	$565.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.01 / $101.52 / $344.00	Professional		$63.01	$101.52	$344.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.00 / $29.46 / $115.78	Professional	26	$20.00	$29.46	$115.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.96 / $67.12 / $148.30	Professional	TC	$40.96	$67.12	$148.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.56 / $72.33 / $114.87	Professional		$59.56	$72.33	$114.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.65 / $29.05 / $51.50	Professional	26	$20.65	$29.05	$51.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.28 / $45.99 / $64.92	Professional	TC	$43.28	$45.99	$64.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.05 / $293.64 / $511.64	Facility		$121.05	$293.64	$511.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.92 / $62.01 / $87.45	Professional		$22.92	$62.01	$87.45
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $80.51 / $152.28 / $824.51	Facility		$80.51	$152.28	$824.51
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $92.59 / $141.85	Professional		$72.45	$92.59	$141.85
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.23 / $86.80 / $106.05	Facility		$80.23	$86.80	$106.05
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $54.10 / $54.10 / $59.37	Facility	TC	$54.10	$54.10	$59.37
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.14 / $28.01 / $56.47	Professional	26	$26.14	$28.01	$56.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.35 / $242.69 / $441.16	Facility		$106.35	$242.69	$441.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $31.67	Facility	26	$31.67	$31.67	$31.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $66.73	Facility	TC	$66.73	$66.73	$66.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $95.96 / $182.81	Professional		$69.48	$95.96	$182.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.45 / $29.71 / $56.02	Professional	26	$22.45	$29.71	$56.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.95 / $67.59 / $132.22	Professional	TC	$46.95	$67.59	$132.22
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $188.97 / $539.87 / $539.87	Facility		$188.97	$539.87	$539.87
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $136.18 / $136.18	Facility	26	$85.90	$136.18	$136.18
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $118.69 / $323.95 / $323.95	Facility	TC	$118.69	$323.95	$323.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $568.24 / $568.24 / $725.78	Professional		$568.24	$568.24	$725.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $227.85 / $227.85 / $227.85	Professional	26	$227.85	$227.85	$227.85
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $390.02 / $390.02 / $501.90	Professional	TC	$390.02	$390.02	$501.90
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $117.60 / $552.50	Facility		$77.84	$117.60	$552.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $98.65 / $185.54	Professional		$40.22	$98.65	$185.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.50 / $42.96 / $107.40	Professional	26	$31.50	$42.96	$107.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.15 / $85.88 / $229.00	Professional	TC	$67.15	$85.88	$229.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $57.83 / $90.66 / $285.88	Facility		$57.83	$90.66	$285.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.13 / $68.65 / $138.19	Professional		$30.13	$68.65	$138.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.14 / $114.90 / $227.40	Facility		$74.14	$114.90	$227.40
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $31.67	Facility	26	$31.67	$31.67	$31.67
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $66.73	Facility	TC	$66.73	$66.73	$66.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.87 / $98.66 / $207.36	Professional		$70.87	$98.66	$207.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.45 / $28.61 / $52.94	Professional	26	$22.45	$28.61	$52.94
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $46.83 / $65.26 / $131.41	Professional	TC	$46.83	$65.26	$131.41
United Facility/Professional Facility Modifier Low / Median / High Price $108.97 / $166.72 / $250.18	Facility		$108.97	$166.72	$250.18
United Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $98.66 / $148.40	Professional		$75.59	$98.66	$148.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.76 / $31.27 / $49.43	Professional	26	$23.76	$31.27	$49.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.83 / $68.05 / $100.24	Professional	TC	$51.83	$68.05	$100.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.78 / $80.51 / $114.21	Professional		$71.78	$80.51	$114.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.92 / $26.41 / $36.97	Professional	26	$22.92	$26.41	$36.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $48.86 / $54.10 / $77.77	Professional	TC	$48.86	$54.10	$77.77