Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $52.48 / $87.10	Facility	26	$48.98	$52.48	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $218.78 / $389.05	Professional		$173.78	$218.78	$389.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $204.17 / $281.84	Professional		$95.50	$204.17	$281.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $257.04 / $309.03	Professional		$229.09	$257.04	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $251.19 / $407.38	Professional		$177.83	$251.19	$407.38
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $457.09 / $457.09 / $457.09	Facility	26	$457.09	$457.09	$457.09
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,089.30 / $2,089.30	Professional		$1,548.82	$2,089.30	$2,089.30
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $52.48 / $53.70	Facility	26	$48.98	$52.48	$53.70
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $331.13 / $724.44	Professional		$173.78	$331.13	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $58.88 / $204.17	Professional		$32.36	$58.88	$204.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $446.68 / $478.63	Professional		$380.19	$446.68	$478.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $426.58	Professional		$173.78	$245.47	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $354.81	Professional		$173.78	$245.47	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $251.19	Professional		$239.88	$239.88	$251.19