Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.40 / $110.72 / $220.54	Professional		$89.40	$110.72	$220.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.39 / $28.17 / $57.93	Professional	26	$21.39	$28.17	$57.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.49 / $73.61 / $161.90	Professional	TC	$51.49	$73.61	$161.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.28 / $76.86 / $190.54	Professional		$62.28	$76.86	$190.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $16.61 / $46.09	Professional	26	$16.55	$16.61	$46.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.28 / $50.28 / $53.50	Professional	TC	$50.28	$50.28	$53.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.73 / $68.66 / $214.90	Professional		$25.73	$68.66	$214.90
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $120.29 / $154.00 / $233.72	Professional		$120.29	$154.00	$233.72
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $32.35 / $32.77 / $33.82	Professional	26	$32.35	$32.77	$33.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.89 / $78.59 / $243.53	Professional		$48.89	$78.59	$243.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $24.88 / $67.38	Professional	26	$17.07	$24.88	$67.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.00 / $55.81 / $184.75	Professional	TC	$28.00	$55.81	$184.75
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $173.52 / $173.52	Facility	26	$100.00	$173.52	$173.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $973.09 / $973.09 / $1,210.28	Professional		$973.09	$973.09	$1,210.28
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $236.03 / $237.42 / $277.27	Professional	26	$236.03	$237.42	$277.27
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $750.23 / $750.23 / $933.00	Professional	TC	$750.23	$750.23	$933.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $101.46 / $196.08 / $260.51	Professional		$101.46	$196.08	$260.51
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.05 / $50.46 / $79.18	Professional	26	$42.05	$50.46	$79.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.03 / $159.63 / $263.45	Professional	TC	$133.03	$159.63	$263.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.76 / $120.37 / $247.36	Professional		$34.76	$120.37	$247.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.49 / $107.84 / $368.91	Professional		$49.49	$107.84	$368.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $21.97 / $69.34	Professional	26	$17.07	$21.97	$69.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.38 / $57.46 / $181.22	Professional	TC	$28.38	$57.46	$181.22
United Facility/Professional Professional Modifier Low / Median / High Price $57.46 / $79.36 / $256.95	Professional		$57.46	$79.36	$256.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.52 / $24.71 / $76.59	Professional	26	$22.52	$24.71	$76.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.29 / $54.57 / $172.80	Professional	TC	$33.29	$54.57	$172.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $77.55 / $140.00	Professional		$41.39	$77.55	$140.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.64 / $18.05 / $33.85	Professional	26	$14.64	$18.05	$33.85
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $59.51 / $106.15	Professional	TC	$24.92	$59.51	$106.15