Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.88 / $41.30 / $63.80	Facility	26	$31.88	$41.30	$63.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.15 / $267.42 / $505.16	Professional		$206.15	$267.42	$505.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.88 / $44.68 / $177.53	Professional	26	$31.88	$44.68	$177.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.27 / $226.80 / $428.87	Professional	TC	$174.27	$226.80	$428.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.46 / $47.85 / $91.31	Professional	26	$37.46	$47.85	$91.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.92 / $236.44 / $336.69	Professional		$40.92	$236.44	$336.69
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $209.00 / $209.00 / $239.00	Professional		$209.00	$209.00	$239.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $46.34 / $47.88 / $52.51	Professional	26	$46.34	$47.88	$52.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.95 / $376.73 / $675.28	Professional		$244.95	$376.73	$675.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.95 / $61.12 / $98.88	Professional	26	$40.95	$61.12	$98.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.00 / $313.14 / $581.07	Professional	TC	$204.00	$313.14	$581.07
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $241.59 / $241.59	Facility	26	$117.49	$241.59	$241.59
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,033.50 / $2,033.50 / $2,498.03	Professional		$2,033.50	$2,033.50	$2,498.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $313.45 / $313.45 / $394.35	Professional	26	$313.45	$313.45	$394.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,720.04 / $1,720.04 / $2,103.67	Professional	TC	$1,720.04	$1,720.04	$2,103.67
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $273.62 / $474.47 / $716.50	Professional		$273.62	$474.47	$716.50
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $99.39 / $428.42	Professional	26	$67.90	$99.39	$428.42
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $342.73 / $428.42 / $960.04	Professional	TC	$342.73	$428.42	$960.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.94 / $348.58 / $637.16	Professional		$81.94	$348.58	$637.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $259.02 / $391.20 / $706.98	Professional		$259.02	$391.20	$706.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $41.82 / $63.01 / $98.88	Professional	26	$41.82	$63.01	$98.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $216.00 / $325.18 / $611.65	Professional	TC	$216.00	$325.18	$611.65
United Facility/Professional Professional Modifier Low / Median / High Price $275.43 / $338.10 / $516.44	Professional		$275.43	$338.10	$516.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.50 / $51.56 / $80.66	Professional	26	$40.50	$51.56	$80.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.41 / $282.47 / $435.78	Professional	TC	$232.41	$282.47	$435.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $245.42 / $273.62 / $390.66	Professional		$245.42	$273.62	$390.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.58 / $46.82 / $64.59	Professional	26	$40.58	$46.82	$64.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $204.84 / $226.80 / $326.05	Professional	TC	$204.84	$226.80	$326.05