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 / $63.67	Facility	26	$31.88	$41.30	$63.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.07 / $318.02 / $688.07	Professional		$238.07	$318.02	$688.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.88 / $44.74 / $99.66	Professional	26	$31.88	$44.74	$99.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $206.19 / $263.98 / $500.71	Professional	TC	$206.19	$263.98	$500.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.31 / $218.31 / $433.80	Professional		$218.31	$218.31	$433.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.72 / $66.06 / $91.97	Professional	26	$37.72	$66.06	$91.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $271.43 / $378.22	Professional		$41.20	$271.43	$378.22
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $217.00 / $498.98 / $594.16	Professional		$217.00	$498.98	$594.16
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $46.67 / $49.14 / $49.14	Professional	26	$46.67	$49.14	$49.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.49 / $399.29 / $658.68	Professional		$272.49	$399.29	$658.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.25 / $61.54 / $100.65	Professional	26	$41.25	$61.54	$100.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.80 / $336.15 / $561.86	Professional	TC	$232.80	$336.15	$561.86
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $118.60 / $242.96 / $242.96	Facility	26	$118.60	$242.96	$242.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,348.14 / $2,348.14 / $2,851.13	Professional		$2,348.14	$2,348.14	$2,851.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $379.76 / $379.76 / $396.68	Professional	26	$379.76	$379.76	$396.68
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,034.68 / $2,034.68 / $2,454.38	Professional	TC	$2,034.68	$2,034.68	$2,454.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $311.86 / $541.17 / $826.89	Professional		$311.86	$541.17	$826.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.36 / $85.45 / $191.48	Professional	26	$68.36	$85.45	$191.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $400.01 / $500.01 / $1,120.48	Professional	TC	$400.01	$500.01	$1,120.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $337.84 / $399.07	Professional		$57.73	$337.84	$399.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $283.38 / $418.69 / $692.00	Professional		$283.38	$418.69	$692.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $65.31 / $103.15	Professional	26	$42.21	$65.31	$103.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $239.26 / $353.26 / $589.30	Professional	TC	$239.26	$353.26	$589.30
United Facility/Professional Professional Modifier Low / Median / High Price $293.11 / $353.65 / $561.85	Professional		$293.11	$353.65	$561.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.02 / $52.90 / $79.48	Professional	26	$43.02	$52.90	$79.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.34 / $302.58 / $496.03	Professional	TC	$248.34	$302.58	$496.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $279.93 / $311.86 / $445.62	Professional		$279.93	$311.86	$445.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.86 / $47.16 / $65.04	Professional	26	$40.86	$47.16	$65.04
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $239.07 / $264.70 / $380.58	Professional	TC	$239.07	$264.70	$380.58