Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.16 / $93.06 / $188.56	Professional		$71.16	$93.06	$188.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.66 / $36.42 / $109.87	Professional	26	$26.66	$36.42	$109.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.49 / $59.73 / $163.40	Professional	TC	$46.49	$59.73	$163.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.75 / $127.00 / $260.58	Professional		$107.75	$127.00	$260.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $39.90 / $92.37	Professional	26	$19.95	$39.90	$92.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.93 / $65.30 / $166.99	Professional		$52.93	$65.30	$166.99
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $107.42 / $152.63 / $191.78	Professional		$107.42	$152.63	$191.78
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $39.04 / $39.47 / $40.93	Professional	26	$39.04	$39.47	$40.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.59 / $82.14 / $223.95	Professional		$56.59	$82.14	$223.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $30.07 / $91.91	Professional	26	$20.51	$30.07	$91.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.08 / $51.99 / $142.53	Professional	TC	$36.08	$51.99	$142.53
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $127.94 / $237.42 / $237.42	Facility	26	$127.94	$237.42	$237.42
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $881.27 / $907.71 / $960.68	Professional		$881.27	$907.71	$960.68
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $341.88 / $342.38 / $342.38	Professional	26	$341.88	$342.38	$342.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $549.40 / $565.88 / $629.17	Professional	TC	$549.40	$565.88	$629.17
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $131.66 / $168.36 / $246.91	Professional		$131.66	$168.36	$246.91
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.54 / $60.65 / $95.94	Professional	26	$50.54	$60.65	$95.94
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.76 / $107.72 / $172.83	Professional	TC	$89.76	$107.72	$172.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.90 / $84.83 / $200.71	Professional		$41.90	$84.83	$200.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $114.80 / $300.69	Professional		$59.50	$114.80	$300.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $30.16 / $91.91	Professional	26	$20.51	$30.16	$91.91
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $36.08 / $51.99 / $142.53	Professional	TC	$36.08	$51.99	$142.53
United Facility/Professional Professional Modifier Low / Median / High Price $77.52 / $93.69 / $273.10	Professional		$77.52	$93.69	$273.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.94 / $36.53 / $102.43	Professional	26	$27.94	$36.53	$102.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.58 / $59.06 / $163.87	Professional	TC	$49.58	$59.06	$163.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $61.79 / $112.36	Professional		$50.39	$61.79	$112.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $22.33 / $40.72	Professional	26	$18.16	$22.33	$40.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $39.90 / $71.63	Professional	TC	$32.22	$39.90	$71.63