Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.87 / $69.91 / $107.04	Facility	26	$53.87	$69.91	$107.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.91 / $112.32 / $224.39	Professional		$86.91	$112.32	$224.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.66 / $88.66 / $128.52	Professional		$88.66	$88.66	$128.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.80 / $129.40 / $188.62	Professional		$74.80	$129.40	$188.62
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $139.33 / $202.66 / $253.32	Professional		$139.33	$202.66	$253.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.44 / $147.41 / $265.72	Professional		$104.44	$147.41	$265.72
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $198.65 / $464.00 / $464.00	Facility	26	$198.65	$464.00	$464.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,114.00 / $1,114.00 / $1,114.00	Professional		$1,114.00	$1,114.00	$1,114.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $126.66 / $215.62 / $304.57	Professional		$126.66	$215.62	$304.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.39 / $134.10 / $224.61	Professional		$86.39	$134.10	$224.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $107.66 / $151.41 / $274.39	Professional		$107.66	$151.41	$274.39
United Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $141.47 / $224.64	Professional		$120.25	$141.47	$224.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $111.53 / $126.66 / $177.46	Professional		$111.53	$126.66	$177.46