Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.94 / $68.78 / $137.77	Professional		$55.94	$68.78	$137.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.47 / $51.10 / $142.10	Professional	26	$37.47	$51.10	$142.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $24.42 / $46.72	Professional	TC	$19.39	$24.42	$46.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.69 / $167.69 / $167.69	Professional		$167.69	$167.69	$167.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.16 / $56.84 / $76.73	Professional	26	$28.16	$56.84	$76.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.00 / $40.00 / $40.00	Professional	TC	$40.00	$40.00	$40.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $85.39 / $130.93	Professional		$51.45	$85.39	$130.93
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $85.57 / $120.08 / $165.00	Professional		$85.57	$120.08	$165.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $55.50 / $56.30 / $58.18	Professional	26	$55.50	$56.30	$58.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $56.96 / $169.84	Professional		$42.70	$56.96	$169.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.03 / $37.04 / $111.65	Professional	26	$29.03	$37.04	$111.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.73 / $21.26 / $56.02	Professional	TC	$12.73	$21.26	$56.02
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $145.58 / $298.82 / $298.82	Facility	26	$145.58	$298.82	$298.82
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $587.10 / $587.10 / $746.40	Professional		$587.10	$587.10	$746.40
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $381.48 / $381.48 / $479.33	Professional	26	$381.48	$381.48	$479.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.55 / $205.55 / $267.08	Professional	TC	$205.55	$205.55	$267.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $59.84 / $114.80 / $207.88	Professional		$59.84	$114.80	$207.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.38 / $86.85 / $135.54	Professional	26	$72.38	$86.85	$135.54
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.01 / $45.62 / $72.38	Professional	TC	$38.01	$45.62	$72.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.61 / $64.64 / $156.47	Professional		$30.61	$64.64	$156.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.79 / $86.93 / $232.54	Professional		$42.79	$86.93	$232.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.03 / $37.04 / $111.18	Professional	26	$29.03	$37.04	$111.18
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $13.48 / $21.46 / $56.02	Professional	TC	$13.48	$21.46	$56.02
United Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $61.01 / $184.06	Professional		$54.71	$61.01	$184.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $39.96 / $130.63	Professional	26	$36.09	$39.96	$130.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $21.48 / $56.00	Professional	TC	$16.03	$21.48	$56.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.89 / $47.37 / $88.54	Professional		$35.89	$47.37	$88.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.47 / $30.87 / $58.23	Professional	26	$25.47	$30.87	$58.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.42 / $16.50 / $30.31	Professional	TC	$10.42	$16.50	$30.31