Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.44 / $322.20 / $556.41	Professional		$263.44	$322.20	$556.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.08 / $125.45 / $299.20	Professional	26	$82.08	$125.45	$299.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $175.68 / $210.96 / $371.56	Professional	TC	$175.68	$210.96	$371.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.32 / $259.24 / $625.00	Professional		$190.32	$259.24	$625.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.58 / $132.74 / $208.87	Professional	26	$65.58	$132.74	$208.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $132.35 / $132.35 / $132.35	Professional	TC	$132.35	$132.35	$132.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $242.88 / $618.14	Professional		$109.58	$242.88	$618.14
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $397.44 / $556.41 / $722.67	Professional		$397.44	$556.41	$722.67
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $129.58 / $131.47 / $136.35	Professional	26	$129.58	$131.47	$136.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.97 / $239.18 / $743.68	Professional		$158.97	$239.18	$743.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $91.52 / $298.63	Professional	26	$66.70	$91.52	$298.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.39 / $154.22 / $503.31	Professional	TC	$88.39	$154.22	$503.31
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $339.46 / $698.35 / $698.35	Facility	26	$339.46	$698.35	$698.35
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,755.28 / $2,755.28 / $3,572.93	Professional		$2,755.28	$2,755.28	$3,572.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $895.79 / $895.79 / $1,118.55	Professional	26	$895.79	$895.79	$1,118.55
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,859.49 / $1,859.49 / $2,454.38	Professional	TC	$1,859.49	$1,859.49	$2,454.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $145.97 / $438.14 / $772.51	Professional		$145.97	$438.14	$772.51
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $169.01 / $202.82 / $318.27	Professional	26	$169.01	$202.82	$318.27
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $350.15 / $420.18 / $653.29	Professional	TC	$350.15	$420.18	$653.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $137.66 / $322.12 / $732.59	Professional		$137.66	$322.12	$732.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $166.04 / $349.33 / $1,086.90	Professional		$166.04	$349.33	$1,086.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $86.97 / $306.00	Professional	26	$66.70	$86.97	$306.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $98.66 / $156.51 / $503.31	Professional	TC	$98.66	$156.51	$503.31
United Facility/Professional Professional Modifier Low / Median / High Price $213.21 / $284.43 / $855.32	Professional		$213.21	$284.43	$855.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.30 / $93.53 / $305.32	Professional	26	$84.30	$93.53	$305.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.88 / $191.63 / $550.00	Professional	TC	$129.88	$191.63	$550.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $164.02 / $223.84 / $415.43	Professional		$164.02	$223.84	$415.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $59.54 / $72.48 / $135.99	Professional	26	$59.54	$72.48	$135.99
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $101.66 / $151.37 / $279.44	Professional	TC	$101.66	$151.37	$279.44