Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.34 / $27.99 / $49.28	Facility	26	$25.34	$27.99	$49.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.19 / $213.21 / $481.68	Professional		$179.19	$213.21	$481.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.53 / $36.43 / $85.38	Professional	26	$25.53	$36.43	$85.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.85 / $178.11 / $390.73	Professional	TC	$153.85	$178.11	$390.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.89 / $246.99 / $279.32	Professional		$172.89	$246.99	$279.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.29 / $39.34 / $50.36	Professional	26	$35.29	$39.34	$50.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $202.40 / $295.08	Professional		$33.95	$202.40	$295.08
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $246.99 / $296.39 / $402.03	Professional		$246.99	$296.39	$402.03
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $37.63 / $37.63	Professional	26	$35.46	$37.63	$37.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.49 / $273.98 / $502.01	Professional		$179.49	$273.98	$502.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.88 / $42.90 / $71.00	Professional	26	$31.88	$42.90	$71.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $149.66 / $235.67 / $430.68	Professional	TC	$149.66	$235.67	$430.68
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $87.34 / $463.50 / $463.50	Facility	26	$87.34	$463.50	$463.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,395.00 / $2,395.00 / $2,395.00	Professional		$2,395.00	$2,395.00	$2,395.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $719.00 / $719.00 / $719.00	Professional	26	$719.00	$719.00	$719.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,676.00 / $1,676.00 / $1,956.98	Professional	TC	$1,676.00	$1,676.00	$1,956.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $106.60 / $390.11 / $564.30	Professional		$106.60	$390.11	$564.30
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.52 / $60.31 / $84.52	Professional	26	$47.52	$60.31	$84.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $290.56 / $368.79 / $521.58	Professional	TC	$290.56	$368.79	$521.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.12 / $276.37 / $458.10	Professional		$44.12	$276.37	$458.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $179.49 / $274.83 / $545.55	Professional		$179.49	$274.83	$545.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.99 / $42.90 / $72.44	Professional	26	$31.99	$42.90	$72.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $146.72 / $236.98 / $449.18	Professional	TC	$146.72	$236.98	$449.18
United Facility/Professional Professional Modifier Low / Median / High Price $211.91 / $276.05 / $459.65	Professional		$211.91	$276.05	$459.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.16 / $60.67	Professional	26	$30.90	$42.16	$60.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.83 / $244.68 / $399.74	Professional	TC	$182.83	$244.68	$399.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $221.96 / $246.99 / $353.39	Professional		$221.96	$246.99	$353.39
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $35.78 / $49.64	Professional	26	$31.19	$35.78	$49.64
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $190.76 / $211.21 / $303.74	Professional	TC	$190.76	$211.21	$303.74