Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.95 / $446.40 / $726.18	Professional		$371.95	$446.40	$726.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.90 / $42.85 / $67.38	Professional	26	$32.90	$42.85	$67.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $338.59 / $400.67 / $658.80	Professional	TC	$338.59	$400.67	$658.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.05 / $267.05 / $514.73	Professional		$267.05	$267.05	$514.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.89 / $17.89 / $57.93	Professional	26	$17.89	$17.89	$57.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $148.74 / $148.74 / $148.74	Professional	TC	$148.74	$148.74	$148.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.44 / $282.33 / $845.38	Professional		$70.44	$282.33	$845.38
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $360.31 / $630.04 / $823.57	Professional		$360.31	$630.04	$823.57
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $52.57 / $53.24 / $55.18	Professional	26	$52.57	$53.24	$55.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.37 / $466.29 / $1,026.77	Professional		$257.37	$466.29	$1,026.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.89 / $47.42 / $105.49	Professional	26	$26.89	$47.42	$105.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.10 / $421.18 / $930.32	Professional	TC	$234.10	$421.18	$930.32
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $137.47 / $280.44 / $280.44	Facility	26	$137.47	$280.44	$280.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,946.60 / $3,946.60 / $4,720.28	Professional		$3,946.60	$3,946.60	$4,720.28
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $363.38 / $363.38 / $451.05	Professional	26	$363.38	$363.38	$451.05
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $3,586.83 / $3,586.83 / $4,269.22	Professional	TC	$3,586.83	$3,586.83	$4,269.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $636.29 / $813.68 / $1,120.80	Professional		$636.29	$813.68	$1,120.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $68.34 / $82.01 / $127.91	Professional	26	$68.34	$82.01	$127.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $609.74 / $731.69 / $1,259.39	Professional	TC	$609.74	$731.69	$1,259.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.93 / $532.48 / $1,051.78	Professional		$59.93	$532.48	$1,051.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $261.12 / $499.67 / $1,535.24	Professional		$261.12	$499.67	$1,535.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.43 / $47.33 / $104.89	Professional	26	$26.43	$47.33	$104.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $221.25 / $417.21 / $930.32	Professional	TC	$221.25	$417.21	$930.32
United Facility/Professional Professional Modifier Low / Median / High Price $305.39 / $387.73 / $1,178.68	Professional		$305.39	$387.73	$1,178.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.02 / $36.15 / $119.52	Professional	26	$35.02	$36.15	$119.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $270.38 / $353.37 / $1,058.14	Professional	TC	$270.38	$353.37	$1,058.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $229.84 / $299.44 / $541.72	Professional		$229.84	$299.44	$541.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.51 / $29.15 / $55.00	Professional	26	$23.51	$29.15	$55.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $206.34 / $270.29 / $486.72	Professional	TC	$206.34	$270.29	$486.72