Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.05 / $35.10 / $55.72	Facility	26	$27.05	$35.10	$55.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.56 / $360.86 / $718.78	Professional		$271.56	$360.86	$718.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.05 / $37.95 / $107.12	Professional	26	$27.05	$37.95	$107.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $244.51 / $322.92 / $637.60	Professional	TC	$244.51	$322.92	$637.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $304.45 / $304.45 / $304.45	Professional		$304.45	$304.45	$304.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $48.94 / $77.59	Professional	26	$31.67	$48.94	$77.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $332.54 / $427.30	Professional		$34.10	$332.54	$427.30
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $201.00 / $573.74 / $609.60	Professional		$201.00	$573.74	$609.60
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $39.39 / $168.23 / $168.23	Professional	26	$39.39	$168.23	$168.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.72 / $493.28 / $909.21	Professional		$311.72	$493.28	$909.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $51.41 / $84.17	Professional	26	$34.54	$51.41	$84.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $286.08 / $447.77 / $829.91	Professional	TC	$286.08	$447.77	$829.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $99.49 / $205.20 / $205.20	Facility	26	$99.49	$205.20	$205.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,679.53 / $2,679.53 / $3,293.78	Professional		$2,679.53	$2,679.53	$3,293.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $266.22 / $266.22 / $336.30	Professional	26	$266.22	$266.22	$336.30
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,413.31 / $2,413.31 / $2,957.48	Professional	TC	$2,413.31	$2,413.31	$2,957.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $358.59 / $623.39 / $1,511.24	Professional		$358.59	$623.39	$1,511.24
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.73 / $72.17 / $161.72	Professional	26	$57.73	$72.17	$161.72
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $481.76 / $602.21 / $1,349.48	Professional	TC	$481.76	$602.21	$1,349.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.55 / $618.79 / $1,288.83	Professional		$73.55	$618.79	$1,288.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $325.97 / $503.83 / $921.00	Professional		$325.97	$503.83	$921.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.29 / $53.16 / $84.17	Professional	26	$35.29	$53.16	$84.17
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $304.61 / $466.87 / $871.17	Professional	TC	$304.61	$466.87	$871.17
United Facility/Professional Professional Modifier Low / Median / High Price $365.81 / $457.26 / $704.63	Professional		$365.81	$457.26	$704.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.67 / $45.14 / $68.58	Professional	26	$36.67	$45.14	$68.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $329.14 / $407.43 / $617.14	Professional	TC	$329.14	$407.43	$617.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $322.45 / $358.59 / $513.20	Professional		$322.45	$358.59	$513.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $34.51 / $39.79 / $54.89	Professional	26	$34.51	$39.79	$54.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $287.94 / $318.80 / $458.30	Professional	TC	$287.94	$318.80	$458.30