Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.34 / $146.54 / $258.70	Facility	26	$134.34	$146.54	$258.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $406.87 / $546.25 / $1,029.33	Professional		$406.87	$546.25	$1,029.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.34 / $174.49 / $316.20	Professional	26	$134.34	$174.49	$316.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $795.45 / $795.45 / $795.45	Professional		$795.45	$795.45	$795.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $191.64 / $239.69 / $269.64	Professional	26	$191.64	$239.69	$269.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $237.11 / $468.62 / $746.51	Professional		$237.11	$468.62	$746.51
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $568.17 / $681.82 / $910.38	Professional		$568.17	$681.82	$910.38
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $189.92 / $197.56 / $200.87	Professional	26	$189.92	$197.56	$200.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $497.43 / $681.82 / $1,136.36	Professional		$497.43	$681.82	$1,136.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $170.74 / $229.96 / $384.07	Professional	26	$170.74	$229.96	$384.07
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $468.94 / $1,008.76 / $1,008.76	Facility	26	$468.94	$1,008.76	$1,008.76
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,771.72 / $3,771.72 / $5,136.53	Professional		$3,771.72	$3,771.72	$5,136.53
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,240.24 / $1,240.24 / $1,637.25	Professional	26	$1,240.24	$1,240.24	$1,637.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $568.17 / $980.45 / $1,331.73	Professional		$568.17	$980.45	$1,331.73
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $254.41 / $322.91 / $441.63	Professional	26	$254.41	$322.91	$441.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $236.11 / $529.04 / $978.14	Professional		$236.11	$529.04	$978.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $497.43 / $690.37 / $1,187.90	Professional		$497.43	$690.37	$1,187.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $170.74 / $229.70 / $384.07	Professional	26	$170.74	$229.70	$384.07
United Facility/Professional Professional Modifier Low / Median / High Price $518.12 / $754.96 / $994.74	Professional		$518.12	$754.96	$994.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $174.85 / $254.26 / $323.13	Professional	26	$174.85	$254.26	$323.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $507.14 / $568.17 / $806.87	Professional		$507.14	$568.17	$806.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $167.02 / $191.64 / $265.80	Professional	26	$167.02	$191.64	$265.80