Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $150.93 / $166.14 / $296.98	Facility	26	$150.93	$166.14	$296.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.98 / $474.78 / $1,401.66	Professional		$323.98	$474.78	$1,401.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $152.04 / $221.96 / $546.21	Professional	26	$152.04	$221.96	$546.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.87 / $242.67 / $594.48	Professional	TC	$169.87	$242.67	$594.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $317.47 / $508.94	Professional		$317.47	$317.47	$508.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $215.24 / $237.31 / $303.35	Professional	26	$215.24	$237.31	$303.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.60 / $397.83 / $642.41	Professional		$200.60	$397.83	$642.41
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $453.53 / $556.03 / $726.14	Professional		$453.53	$556.03	$726.14
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $213.79 / $226.91 / $226.91	Professional	26	$213.79	$226.91	$226.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $410.43 / $596.03 / $1,250.28	Professional		$410.43	$596.03	$1,250.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $192.88 / $262.26 / $436.71	Professional	26	$192.88	$262.26	$436.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.77 / $316.68 / $726.25	Professional	TC	$218.77	$316.68	$726.25
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $528.44 / $1,325.34 / $1,325.34	Facility	26	$528.44	$1,325.34	$1,325.34
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $7,381.05 / $7,602.48 / $7,602.48	Professional		$7,381.05	$7,602.48	$7,602.48
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,699.00 / $1,699.00 / $1,841.48	Professional	26	$1,699.00	$1,699.00	$1,841.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $6,233.93 / $6,420.95 / $6,420.95	Professional	TC	$6,233.93	$6,420.95	$6,420.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $315.77 / $707.91 / $1,062.18	Professional		$315.77	$707.91	$1,062.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $286.36 / $363.46 / $501.01	Professional	26	$286.36	$363.46	$501.01
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $327.16 / $415.24 / $561.17	Professional	TC	$327.16	$415.24	$561.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $255.13 / $393.23 / $826.94	Professional		$255.13	$393.23	$826.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $417.24 / $621.44 / $1,200.46	Professional		$417.24	$621.44	$1,200.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $192.88 / $258.88 / $436.71	Professional	26	$192.88	$258.88	$436.71
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $218.77 / $329.33 / $726.25	Professional	TC	$218.77	$329.33	$726.25
United Facility/Professional Professional Modifier Low / Median / High Price $421.34 / $625.01 / $1,144.46	Professional		$421.34	$625.01	$1,144.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $197.99 / $271.44 / $383.78	Professional	26	$197.99	$271.44	$383.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.06 / $343.77 / $873.02	Professional	TC	$239.06	$343.77	$873.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $402.79 / $453.53 / $640.95	Professional		$402.79	$453.53	$640.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $188.00 / $215.74 / $299.24	Professional	26	$188.00	$215.74	$299.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $214.78 / $237.79 / $341.71	Professional	TC	$214.78	$237.79	$341.71