Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $56.23 / $97.72	Facility	26	$46.77	$56.23	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $707.95	Professional		$346.74	$457.09	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $234.42	Professional	26	$52.48	$69.18	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $371.54 / $562.34	Professional	TC	$295.12	$371.54	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $89.13 / $123.03	Professional	26	$45.71	$89.13	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $354.81 / $478.63	Professional		$60.26	$354.81	$478.63
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $295.12	Professional		$281.84	$281.84	$295.12
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $72.44	Professional	26	$63.10	$63.10	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $537.03 / $933.25	Professional		$354.81	$537.03	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $85.11 / $138.04	Professional	26	$56.23	$85.11	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $478.63 / $794.33	Professional	TC	$295.12	$478.63	$794.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $426.58 / $426.58 / $426.58	Facility	26	$426.58	$426.58	$426.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,548.13 / $3,548.13	Professional		$2,951.21	$3,548.13	$3,548.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $537.03 / $537.03	Professional	26	$426.58	$537.03	$537.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,511.89 / $3,019.95 / $3,019.95	Professional	TC	$2,511.89	$3,019.95	$3,019.95
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $56.23 / $97.72	Facility	26	$42.66	$56.23	$97.72
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $602.56 / $1,479.11	Professional		$363.08	$602.56	$1,479.11
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $93.33 / $251.19	Professional	26	$54.95	$93.33	$251.19
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $512.86 / $1,047.13	Professional	TC	$302.00	$512.86	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $309.03	Professional		$32.36	$33.11	$309.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $512.86 / $891.25	Professional		$371.54	$512.86	$891.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $131.83	Professional	26	$56.23	$75.86	$131.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $457.09 / $794.33	Professional	TC	$295.12	$457.09	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $489.78 / $758.58	Professional		$407.38	$489.78	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $70.79 / $109.65	Professional	26	$58.88	$70.79	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $426.58 / $645.65	Professional	TC	$346.74	$426.58	$645.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $398.11 / $416.87	Professional		$398.11	$398.11	$416.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	26	$66.07	$66.07	$66.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $354.81	Professional	TC	$338.84	$338.84	$354.81