Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.04 / $126.79 / $375.94	Professional		$103.04	$126.79	$375.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.20 / $30.26 / $115.95	Professional	26	$23.20	$30.26	$115.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.83 / $86.27 / $254.87	Professional	TC	$72.83	$86.27	$254.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $82.43 / $227.17	Professional		$76.09	$82.43	$227.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $35.60 / $56.01	Professional	26	$17.80	$35.60	$56.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.63 / $61.90 / $71.04	Professional	TC	$58.63	$61.90	$71.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.26 / $79.38 / $237.67	Professional		$46.26	$79.38	$237.67
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $56.60 / $168.42 / $252.69	Professional		$56.60	$168.42	$252.69
Christus Facility/Professional Facility Modifier Low / Median / High Price $153.08 / $166.58 / $195.93	Facility		$153.08	$166.58	$195.93
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $34.77 / $35.25 / $36.51	Professional	26	$34.77	$35.25	$36.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $89.50 / $298.67	Professional		$55.80	$89.50	$298.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $21.77 / $68.77	Professional	26	$18.37	$21.77	$68.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.63 / $69.42 / $229.13	Professional	TC	$36.63	$69.42	$229.13
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $528.48 / $928.91 / $928.91	Facility		$528.48	$928.91	$928.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,081.50 / $1,081.50 / $1,445.93	Professional		$1,081.50	$1,081.50	$1,445.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $235.79 / $235.79 / $299.10	Professional	26	$235.79	$235.79	$299.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $845.71 / $845.71 / $1,146.83	Professional	TC	$845.71	$845.71	$1,146.83
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $116.66 / $183.31 / $303.95	Facility		$116.66	$183.31	$303.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $141.30 / $234.12 / $316.77	Professional		$141.30	$234.12	$316.77
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $54.35 / $83.75	Professional	26	$45.29	$54.35	$83.75
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $163.75 / $196.50 / $296.95	Professional	TC	$163.75	$196.50	$296.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.97 / $144.88 / $301.68	Professional		$36.97	$144.88	$301.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $115.10 / $183.31 / $337.41	Facility		$115.10	$183.31	$337.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.83 / $128.59 / $409.90	Professional		$55.83	$128.59	$409.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $21.77 / $66.84	Professional	26	$18.37	$21.77	$66.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $36.63 / $69.00 / $217.72	Professional	TC	$36.63	$69.00	$217.72
United Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $107.14 / $347.82	Professional		$74.36	$107.14	$347.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.04 / $25.47 / $80.12	Professional	26	$24.04	$25.47	$80.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.89 / $81.20 / $268.38	Professional	TC	$48.89	$81.20	$268.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $68.41 / $89.45 / $167.16	Professional		$68.41	$89.45	$167.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.62 / $19.26 / $36.45	Professional	26	$15.62	$19.26	$36.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $52.78 / $70.19 / $130.71	Professional	TC	$52.78	$70.19	$130.71