Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.70 / $79.00 / $140.87	Facility	26	$71.70	$79.00	$140.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $146.26 / $495.43	Professional		$92.03	$146.26	$495.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.22 / $105.45 / $266.37	Professional	26	$72.22	$105.45	$266.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $27.96 / $145.90	Professional	TC	$19.80	$27.96	$145.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.46 / $144.79 / $239.71	Professional		$110.46	$144.79	$239.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $102.32 / $122.78 / $177.01	Professional	26	$102.32	$122.78	$177.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.75 / $140.68 / $219.43	Professional		$86.75	$140.68	$219.43
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $142.58 / $169.27 / $216.69	Professional		$142.58	$169.27	$216.69
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $101.40 / $107.97 / $107.97	Professional	26	$101.40	$107.97	$107.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.27 / $189.14 / $413.05	Professional		$120.27	$189.14	$413.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.78 / $122.78 / $207.73	Professional	26	$91.78	$122.78	$207.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $49.05 / $159.94	Professional	TC	$25.05	$49.05	$159.94
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $250.54 / $722.52 / $722.52	Facility	26	$250.54	$722.52	$722.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,014.42 / $3,104.86 / $3,104.86	Professional		$3,014.42	$3,104.86	$3,104.86
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $873.45 / $1,056.82 / $1,056.82	Professional	26	$873.45	$1,056.82	$1,056.82
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,488.46 / $2,563.11 / $2,563.11	Professional	TC	$2,488.46	$2,563.11	$2,563.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $138.07 / $213.48 / $316.39	Professional		$138.07	$213.48	$316.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.82 / $172.39 / $238.33	Professional	26	$135.82	$172.39	$238.33
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.21 / $62.45 / $67.56	Professional	TC	$49.21	$62.45	$67.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.54 / $136.53 / $233.95	Professional		$44.54	$136.53	$233.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $121.20 / $193.15 / $393.59	Professional		$121.20	$193.15	$393.59
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $91.78 / $122.78 / $207.73	Professional	26	$91.78	$122.78	$207.73
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.50 / $49.69 / $159.94	Professional	TC	$25.50	$49.69	$159.94
United Facility/Professional Professional Modifier Low / Median / High Price $123.10 / $182.67 / $446.23	Professional		$123.10	$182.67	$446.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.64 / $124.59 / $181.87	Professional	26	$88.64	$124.59	$181.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $48.06 / $321.64	Professional	TC	$24.65	$48.06	$321.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $121.47 / $138.07 / $193.27	Professional		$121.47	$138.07	$193.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $89.17 / $102.32 / $141.94	Professional	26	$89.17	$102.32	$141.94
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $35.76 / $51.34	Professional	TC	$32.29	$35.76	$51.34