Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.37 / $75.50 / $88.69	Facility	26	$58.37	$75.50	$88.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.80 / $190.38 / $848.03	Professional		$129.80	$190.38	$848.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.76 / $81.77 / $174.41	Professional	26	$62.76	$81.77	$174.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.59 / $173.24 / $292.58	Professional		$138.59	$173.24	$292.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.98 / $89.22 / $166.33	Professional	26	$67.98	$89.22	$166.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.11 / $135.74 / $189.21	Professional		$73.11	$135.74	$189.21
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $155.09 / $206.78 / $331.54	Professional		$155.09	$206.78	$331.54
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $84.12 / $91.64 / $139.12	Professional	26	$84.12	$91.64	$139.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.77 / $193.22 / $369.04	Professional		$139.77	$193.22	$369.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.88 / $96.21 / $176.81	Professional	26	$72.88	$96.21	$176.81
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $213.26 / $442.37 / $442.37	Facility	26	$213.26	$442.37	$442.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,463.47 / $1,466.63 / $1,511.77	Professional		$1,463.47	$1,466.63	$1,511.77
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $605.95 / $625.94 / $713.48	Professional	26	$605.95	$625.94	$713.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.15 / $263.07 / $462.93	Professional		$138.15	$263.07	$462.93
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.31 / $129.56 / $345.48	Professional	26	$101.31	$129.56	$345.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.19 / $118.04 / $302.08	Professional		$58.19	$118.04	$302.08
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.02 / $199.67 / $399.01	Professional		$143.02	$199.67	$399.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $73.95 / $92.84 / $172.23	Professional	26	$73.95	$92.84	$172.23
United Facility/Professional Professional Modifier Low / Median / High Price $148.09 / $194.37 / $290.56	Professional		$148.09	$194.37	$290.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.33 / $99.23 / $150.66	Professional	26	$75.33	$99.23	$150.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $146.87 / $165.97 / $233.87	Professional		$146.87	$165.97	$233.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $73.70 / $84.98 / $118.97	Professional	26	$73.70	$84.98	$118.97