Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $95.80 / $269.58	Professional		$71.48	$95.80	$269.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.41 / $46.96 / $213.31	Professional	26	$25.41	$46.96	$213.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.87 / $61.58 / $137.05	Professional	TC	$47.87	$61.58	$137.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.05 / $63.61 / $119.80	Professional		$53.05	$63.61	$119.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $38.19 / $60.08	Professional	26	$18.89	$38.19	$60.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $44.90 / $74.34	Professional	TC	$36.22	$44.90	$74.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $63.22 / $166.99	Professional		$29.52	$63.22	$166.99
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $127.74 / $204.63	Professional		$62.30	$127.74	$204.63
Christus Facility/Professional Facility Modifier Low / Median / High Price $106.56 / $116.39 / $118.06	Facility		$106.56	$116.39	$118.06
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $37.32 / $37.79 / $39.36	Professional	26	$37.32	$37.79	$39.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.19 / $71.51 / $221.14	Professional		$55.19	$71.51	$221.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $28.58 / $87.71	Professional	26	$19.68	$28.58	$87.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.81 / $44.41 / $146.34	Professional	TC	$30.81	$44.41	$146.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $290.76 / $633.51 / $633.51	Facility		$290.76	$633.51	$633.51
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $117.99 / $221.64 / $221.64	Facility	26	$117.99	$221.64	$221.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $764.45 / $764.45 / $991.43	Professional		$764.45	$764.45	$991.43
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $310.87 / $311.07 / $319.80	Professional	26	$310.87	$311.07	$319.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $507.20 / $507.20 / $671.63	Professional	TC	$507.20	$507.20	$671.63
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $98.93 / $143.19 / $215.04	Facility		$98.93	$143.19	$215.04
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $150.47 / $297.00	Professional		$55.15	$150.47	$297.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.53 / $58.23 / $91.37	Professional	26	$48.53	$58.23	$91.37
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.83 / $114.99 / $178.18	Professional	TC	$95.83	$114.99	$178.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $91.93 / $208.96	Professional		$40.40	$91.93	$208.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $92.14 / $143.82 / $238.89	Facility		$92.14	$143.82	$238.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $105.79 / $318.07	Professional		$55.32	$105.79	$318.07
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $28.33 / $89.12	Professional	26	$19.68	$28.33	$89.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.81 / $42.50 / $146.34	Professional	TC	$30.81	$42.50	$146.34
United Facility/Professional Professional Modifier Low / Median / High Price $72.29 / $81.86 / $254.80	Professional		$72.29	$81.86	$254.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.42 / $33.02 / $96.87	Professional	26	$26.42	$33.02	$96.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.10 / $53.78 / $166.74	Professional	TC	$39.10	$53.78	$166.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $62.28 / $115.54	Professional		$49.69	$62.28	$115.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $20.82 / $39.06	Professional	26	$17.17	$20.82	$39.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.51 / $41.46 / $76.48	Professional	TC	$32.51	$41.46	$76.48