Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.46 / $39.57 / $62.38	Facility	26	$30.46	$39.57	$62.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.33 / $162.33 / $473.50	Professional		$118.33	$162.33	$473.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.60 / $45.37 / $78.87	Professional	26	$34.60	$45.37	$78.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.18 / $109.83 / $181.24	Professional	TC	$77.18	$109.83	$181.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.23 / $124.88 / $230.48	Professional		$113.23	$124.88	$230.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.43 / $48.28 / $86.89	Professional	26	$35.43	$48.28	$86.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $71.67 / $71.67 / $81.92	Professional	TC	$71.67	$71.67	$81.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $115.55 / $178.01	Professional		$38.36	$115.55	$178.01
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $143.07 / $220.43 / $286.55	Professional		$143.07	$220.43	$286.55
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $44.11 / $47.60 / $49.98	Professional	26	$44.11	$47.60	$49.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.20 / $178.67 / $324.32	Professional		$124.20	$178.67	$324.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $53.23 / $97.03	Professional	26	$37.88	$53.23	$97.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.42 / $127.57 / $228.44	Professional	TC	$89.42	$127.57	$228.44
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $111.37 / $230.38 / $230.38	Facility	26	$111.37	$230.38	$230.38
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,024.30 / $1,024.30 / $1,326.30	Professional		$1,024.30	$1,024.30	$1,326.30
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $300.10 / $300.10 / $376.28	Professional	26	$300.10	$300.10	$376.28
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $724.19 / $724.19 / $950.03	Professional	TC	$724.19	$724.19	$950.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $83.84 / $221.00 / $490.50	Professional		$83.84	$221.00	$490.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $74.73 / $181.16	Professional	26	$58.88	$74.73	$181.16
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $171.28 / $171.28 / $171.28	Professional	52	$171.28	$171.28	$171.28
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $140.87 / $178.79 / $433.44	Professional	TC	$140.87	$178.79	$433.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $135.91 / $259.50	Professional		$52.49	$135.91	$259.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.31 / $198.38 / $419.76	Professional		$127.31	$198.38	$419.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.78 / $51.49 / $94.61	Professional	26	$38.78	$51.49	$94.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $89.98 / $124.43 / $221.24	Professional	TC	$89.98	$124.43	$221.24
United Facility/Professional Professional Modifier Low / Median / High Price $137.43 / $187.87 / $274.66	Professional		$137.43	$187.87	$274.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.00 / $55.92 / $81.97	Professional	26	$41.00	$55.92	$81.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.21 / $132.59 / $195.27	Professional	TC	$98.21	$132.59	$195.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.13 / $146.94 / $208.71	Professional		$131.13	$146.94	$208.71
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.65 / $44.56 / $61.51	Professional	26	$38.65	$44.56	$61.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $92.48 / $102.39 / $147.19	Professional	TC	$92.48	$102.39	$147.19