Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.91 / $77.56 / $118.17	Facility	26	$59.91	$77.56	$118.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.27 / $121.65 / $251.49	Professional		$94.27	$121.65	$251.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.36 / $43.37 / $92.77	Professional	TC	$34.36	$43.37	$92.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.28 / $145.28 / $145.28	Professional		$145.28	$145.28	$145.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.75 / $155.43 / $207.70	Professional		$101.75	$155.43	$207.70
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $141.32 / $170.33 / $243.38	Professional		$141.32	$170.33	$243.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.45 / $163.74 / $293.07	Professional		$111.45	$163.74	$293.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.13 / $58.33 / $117.27	Professional	TC	$39.13	$58.33	$117.27
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $219.19 / $454.05 / $454.05	Facility	26	$219.19	$454.05	$454.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,161.00 / $1,161.00 / $1,194.83	Professional		$1,161.00	$1,161.00	$1,194.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $585.04 / $602.60 / $602.60	Professional	TC	$585.04	$602.60	$602.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $136.72 / $232.70 / $329.69	Professional		$136.72	$232.70	$329.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.70 / $85.93 / $119.55	Professional	TC	$67.70	$85.93	$119.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.16 / $117.92 / $230.82	Professional		$61.16	$117.92	$230.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.22 / $165.64 / $295.77	Professional		$116.22	$165.64	$295.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.67 / $59.78 / $108.65	Professional	TC	$41.67	$59.78	$108.65
United Facility/Professional Professional Modifier Low / Median / High Price $129.76 / $152.66 / $251.89	Professional		$129.76	$152.66	$251.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.50 / $58.25 / $98.47	Professional	TC	$43.50	$58.25	$98.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $136.72 / $191.62	Professional		$120.36	$136.72	$191.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $44.45 / $49.21 / $70.69	Professional	TC	$44.45	$49.21	$70.69