Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.58 / $92.31 / $578.76	Professional		$67.58	$92.31	$578.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $22.75 / $54.80	Professional	26	$17.07	$22.75	$54.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.43 / $57.28 / $142.84	Professional	TC	$41.43	$57.28	$142.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.68 / $58.78 / $145.61	Professional		$47.68	$58.78	$145.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $13.43 / $28.02	Professional	26	$13.36	$13.43	$28.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.75 / $37.75 / $40.13	Professional	TC	$37.75	$37.75	$40.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.01 / $49.04 / $164.62	Professional		$35.01	$49.04	$164.62
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $81.78 / $113.09 / $166.73	Professional		$81.78	$113.09	$166.73
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.11 / $26.46 / $27.59	Professional	26	$26.11	$26.46	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.49 / $58.71 / $185.96	Professional		$34.49	$58.71	$185.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $17.48 / $52.43	Professional	26	$13.69	$17.48	$52.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.80 / $44.15 / $134.68	Professional	TC	$20.80	$44.15	$134.68
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $68.33 / $139.56 / $139.56	Facility	26	$68.33	$139.56	$139.56
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $750.04 / $750.04 / $924.23	Professional		$750.04	$750.04	$924.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $179.95 / $179.95 / $224.33	Professional	26	$179.95	$179.95	$224.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $570.15 / $570.15 / $699.90	Professional	TC	$570.15	$570.15	$699.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $78.66 / $149.90 / $199.15	Professional		$78.66	$149.90	$199.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.96 / $40.76 / $63.95	Professional	26	$33.96	$40.76	$63.95
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.88 / $119.85 / $200.24	Professional	TC	$99.88	$119.85	$200.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.34 / $92.45 / $192.48	Professional		$29.34	$92.45	$192.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.50 / $79.86 / $284.47	Professional		$34.50	$79.86	$284.47
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $15.54 / $50.57	Professional	26	$13.36	$15.54	$50.57
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.75 / $43.22 / $132.44	Professional	TC	$20.75	$43.22	$132.44
United Facility/Professional Professional Modifier Low / Median / High Price $43.39 / $56.51 / $188.38	Professional		$43.39	$56.51	$188.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $18.20 / $60.64	Professional	26	$17.18	$18.20	$60.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.21 / $39.07 / $127.74	Professional	TC	$26.21	$39.07	$127.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $58.95 / $107.04	Professional		$29.52	$58.95	$107.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.82 / $14.57 / $27.33	Professional	26	$11.82	$14.57	$27.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $44.38 / $79.70	Professional	TC	$17.48	$44.38	$79.70