Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $61.66 / $69.18	Facility	26	$54.95	$61.66	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $257.04	Professional		$100.00	$125.89	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Professional		$89.13	$89.13	$89.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $131.83 / $173.78	Professional		$77.62	$131.83	$173.78
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $204.17 / $229.09	Professional		$194.98	$204.17	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $269.15	Professional		$112.20	$158.49	$269.15
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $524.81 / $524.81 / $524.81	Facility	26	$524.81	$524.81	$524.81
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Professional		$1,122.02	$1,122.02	$1,122.02
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $57.54 / $69.18	Facility	26	$52.48	$57.54	$69.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $302.00	Professional		$104.71	$173.78	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $112.20	Professional		$32.36	$33.11	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $234.42 / $263.03	Professional		$199.53	$234.42	$263.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $269.15	Professional		$112.20	$147.91	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $234.42	Professional		$120.23	$141.25	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $134.90	Professional		$128.82	$128.82	$134.90