Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.89 / $65.79 / $103.85	Facility	26	$50.89	$65.79	$103.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.93 / $234.24 / $655.20	Professional		$184.93	$234.24	$655.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.28 / $258.01 / $392.31	Professional		$200.28	$258.01	$392.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.84 / $184.03 / $262.86	Professional		$63.84	$184.03	$262.86
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $225.53 / $273.01 / $426.95	Professional		$225.53	$273.01	$426.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.24 / $90.24 / $90.24	Facility	26	$90.24	$90.24	$90.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.72 / $251.24 / $475.50	Professional		$177.72	$251.24	$475.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $186.25 / $385.37 / $385.37	Facility	26	$186.25	$385.37	$385.37
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,708.42 / $1,708.42 / $2,137.05	Professional		$1,708.42	$1,708.42	$2,137.05
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $190.00 / $349.01 / $743.52	Professional		$190.00	$349.01	$743.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.18 / $174.13 / $414.26	Professional		$74.18	$174.13	$414.26
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $90.24 / $90.24 / $90.24	Facility	26	$90.24	$90.24	$90.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $178.61 / $262.04 / $574.20	Professional		$178.61	$262.04	$574.20
United Facility/Professional Professional Modifier Low / Median / High Price $209.05 / $271.20 / $423.44	Professional		$209.05	$271.20	$423.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $211.75 / $237.40 / $337.18	Professional		$211.75	$237.40	$337.18