Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.75 / $30.87 / $48.11	Facility	26	$23.75	$30.87	$48.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.10 / $230.32 / $452.12	Professional		$179.10	$230.32	$452.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.75 / $33.70 / $123.24	Professional	26	$23.75	$33.70	$123.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.13 / $30.30 / $35.64	Professional	26	$29.13	$30.30	$35.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $202.02 / $289.92	Professional		$30.90	$202.02	$289.92
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $154.00 / $154.00 / $154.00	Professional		$154.00	$154.00	$154.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.28 / $36.00 / $38.85	Professional	26	$35.28	$36.00	$38.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.33 / $268.83 / $553.51	Professional		$165.33	$268.83	$553.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.02 / $46.04 / $74.48	Professional	26	$31.02	$46.04	$74.48
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $98.17 / $183.68 / $183.68	Facility	26	$98.17	$183.68	$183.68
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,791.90 / $1,791.90 / $2,235.90	Professional		$1,791.90	$1,791.90	$2,235.90
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $258.60 / $258.60 / $301.95	Professional	26	$258.60	$258.60	$301.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $244.10 / $423.77 / $631.22	Professional		$244.10	$423.77	$631.22
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.74 / $64.67 / $144.91	Professional	26	$51.74	$64.67	$144.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $380.46 / $452.22	Professional		$60.27	$380.46	$452.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.33 / $280.83 / $561.66	Professional		$165.33	$280.83	$561.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.94 / $48.86 / $77.84	Professional	26	$31.94	$48.86	$77.84
United Facility/Professional Professional Modifier Low / Median / High Price $157.51 / $275.44 / $459.06	Professional		$157.51	$275.44	$459.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $39.15 / $59.55	Professional	26	$31.76	$39.15	$59.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $219.20 / $244.10 / $348.84	Professional		$219.20	$244.10	$348.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $35.64 / $49.17	Professional	26	$30.92	$35.64	$49.17