Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.21 / $48.22 / $81.28	Facility	26	$41.21	$48.22	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.87 / $270.67 / $625.79	Professional		$210.87	$270.67	$625.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $54.01 / $261.44	Professional	26	$41.22	$54.01	$261.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.65 / $217.28 / $394.39	Professional	TC	$169.65	$217.28	$394.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.50 / $239.50 / $239.50	Professional		$239.50	$239.50	$239.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.43 / $51.18 / $102.84	Professional	26	$47.43	$51.18	$102.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.62 / $230.37 / $320.16	Professional		$52.62	$230.37	$320.16
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $283.04 / $325.50 / $510.48	Professional		$283.04	$325.50	$510.48
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $59.59 / $65.56 / $65.56	Professional	26	$59.59	$65.56	$65.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.07 / $359.10 / $650.04	Professional		$245.07	$359.10	$650.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.67 / $77.37 / $126.02	Professional	26	$52.67	$77.37	$126.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.05 / $303.89 / $531.88	Professional	TC	$199.05	$303.89	$531.88
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $151.49 / $311.41 / $311.41	Facility	26	$151.49	$311.41	$311.41
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,079.76 / $2,079.76 / $2,572.42	Professional		$2,079.76	$2,079.76	$2,572.42
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $405.29 / $405.29 / $505.58	Professional	26	$405.29	$405.29	$505.58
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,674.47 / $1,674.47 / $2,066.85	Professional	TC	$1,674.47	$1,674.47	$2,066.85
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $283.04 / $512.29 / $733.24	Professional		$283.04	$512.29	$733.24
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.29 / $109.12 / $244.52	Professional	26	$87.29	$109.12	$244.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $336.74 / $420.92 / $943.24	Professional	TC	$336.74	$420.92	$943.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.59 / $283.45 / $562.82	Professional		$73.59	$283.45	$562.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $254.47 / $382.55 / $656.74	Professional		$254.47	$382.55	$656.74
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.03 / $81.04 / $126.02	Professional	26	$54.03	$81.04	$126.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $213.51 / $318.19 / $545.38	Professional	TC	$213.51	$318.19	$545.38
United Facility/Professional Professional Modifier Low / Median / High Price $278.02 / $360.80 / $567.10	Professional		$278.02	$360.80	$567.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.28 / $68.56 / $116.57	Professional	26	$52.28	$68.56	$116.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.17 / $286.99 / $438.99	Professional	TC	$223.17	$286.99	$438.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $253.43 / $283.04 / $403.46	Professional		$253.43	$283.04	$403.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $60.21 / $83.12	Professional	26	$52.17	$60.21	$83.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $201.26 / $222.82 / $320.33	Professional	TC	$201.26	$222.82	$320.33