Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $588.84 / $1,230.27	Facility		$60.26	$588.84	$1,230.27
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $22.91 / $43.65	Facility	26	$19.50	$22.91	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $87.10 / $323.59	Professional		$45.71	$87.10	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $125.89	Professional	26	$23.99	$40.74	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.90 / $169.82	Professional	TC	$19.95	$30.90	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $54.95 / $93.33	Professional		$41.69	$54.95	$93.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $58.88	Professional	26	$22.91	$30.90	$58.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $74.13 / $138.04	Facility		$30.20	$74.13	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $45.71 / $63.10	Professional		$24.55	$45.71	$63.10
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $128.82 / $1,445.44	Facility		$61.66	$128.82	$1,445.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $128.82	Professional		$54.95	$87.10	$128.82
Christus Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $31.62 / $61.66	Facility		$31.62	$31.62	$61.66
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $31.62 / $31.62	Professional	26	$28.18	$31.62	$31.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $812.83 / $891.25	Facility		$316.23	$812.83	$891.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	26	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $91.20 / $263.03	Professional		$47.86	$91.20	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $66.07	Professional	26	$25.12	$35.48	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $42.66 / $218.78	Professional	TC	$21.88	$42.66	$218.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $891.25	Facility		$891.25	$891.25	$891.25
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $954.99 / $954.99	Professional		$72.44	$954.99	$954.99
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $371.54 / $371.54	Professional	26	$371.54	$371.54	$371.54
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $758.58 / $758.58	Professional	TC	$758.58	$758.58	$758.58
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $95.50 / $426.58	Facility		$47.86	$95.50	$426.58
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $22.91 / $42.66	Facility	26	$19.05	$22.91	$42.66
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $83.18 / $239.88	Professional		$44.67	$83.18	$239.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $40.74 / $107.15	Professional	26	$23.99	$40.74	$107.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $38.02 / $151.36	Professional	TC	$20.42	$38.02	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $32.36 / $48.98	Professional		$23.99	$32.36	$48.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $7,943.28 / $9,549.93	Facility		$3,467.37	$7,943.28	$9,549.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $64.57 / $151.36	Professional		$30.90	$64.57	$151.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $100.00 / $288.40	Facility		$52.48	$100.00	$288.40
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	26	$7.41	$34.67	$48.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $97.72 / $269.15	Professional		$47.86	$97.72	$269.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.11 / $61.66	Professional	26	$25.12	$33.11	$61.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $39.81 / $234.42	Professional	TC	$21.88	$39.81	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $72.44 / $208.93	Professional		$50.12	$72.44	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $34.67 / $52.48	Professional	26	$26.30	$34.67	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $173.78	Professional	TC	$22.91	$33.11	$173.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $64.57 / $77.62	Professional		$61.66	$64.57	$77.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $31.62 / $38.02	Professional	26	$30.90	$31.62	$38.02
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $32.36 / $38.90	Professional	TC	$30.90	$32.36	$38.90