Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.86 / $58.99 / $107.84	Facility	26	$54.86	$58.99	$107.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.91 / $161.82 / $383.25	Professional		$132.91	$161.82	$383.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.16 / $176.46 / $316.08	Professional		$141.16	$176.46	$316.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.47 / $143.88 / $199.29	Professional		$68.47	$143.88	$199.29
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $176.46 / $205.40 / $435.41	Professional		$176.46	$205.40	$435.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.73 / $96.73 / $96.73	Facility	26	$96.73	$96.73	$96.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.13 / $199.56 / $379.82	Professional		$152.13	$199.56	$379.82
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $200.27 / $415.82 / $415.82	Facility	26	$200.27	$415.82	$415.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,243.70 / $1,243.70 / $1,567.43	Professional		$1,243.70	$1,243.70	$1,567.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $129.15 / $275.10 / $538.53	Professional		$129.15	$275.10	$538.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.27 / $129.12 / $313.37	Professional		$66.27	$129.12	$313.37
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $96.73 / $96.73 / $96.73	Facility	26	$96.73	$96.73	$96.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $157.57 / $210.92 / $442.25	Professional		$157.57	$210.92	$442.25
United Facility/Professional Professional Modifier Low / Median / High Price $161.97 / $208.82 / $315.26	Professional		$161.97	$208.82	$315.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $156.53 / $176.46 / $249.30	Professional		$156.53	$176.46	$249.30