Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.58 / $99.64 / $256.87	Professional		$80.58	$99.64	$256.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $30.43 / $67.45	Professional	26	$24.33	$30.43	$67.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.21 / $68.29 / $166.56	Professional	TC	$57.21	$68.29	$166.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $69.09 / $167.14	Professional		$69.09	$69.09	$167.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $19.57 / $39.15	Professional	26	$19.57	$19.57	$39.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.52 / $49.52 / $49.52	Professional	TC	$49.52	$49.52	$49.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.43 / $71.15 / $201.15	Professional		$50.43	$71.15	$201.15
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $131.94 / $193.47 / $224.32	Professional		$131.94	$193.47	$224.32
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.28 / $38.76 / $40.35	Professional	26	$38.28	$38.76	$40.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $109.29 / $276.89	Professional		$64.09	$109.29	$276.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $32.81 / $92.84	Professional	26	$20.17	$32.81	$92.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.80 / $78.22 / $200.22	Professional	TC	$42.80	$78.22	$200.22
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $143.06 / $271.50 / $271.50	Facility	26	$143.06	$271.50	$271.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,070.24 / $1,070.24 / $1,246.43	Professional		$1,070.24	$1,070.24	$1,246.43
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $390.67 / $392.28 / $392.28	Professional	26	$390.67	$392.28	$392.28
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $793.60 / $793.60 / $918.90	Professional	TC	$793.60	$793.60	$918.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.81 / $216.89 / $303.80	Professional		$144.81	$216.89	$303.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.74 / $59.69 / $90.62	Professional	26	$49.74	$59.69	$90.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.00 / $157.19 / $213.20	Professional	TC	$131.00	$157.19	$213.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.05 / $125.75 / $262.14	Professional		$44.05	$125.75	$262.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $143.97 / $372.32	Professional		$64.09	$143.97	$372.32
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $20.17 / $31.95 / $93.43	Professional	26	$20.17	$31.95	$93.43
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $42.15 / $74.33 / $189.68	Professional	TC	$42.15	$74.33	$189.68
United Facility/Professional Professional Modifier Low / Median / High Price $74.09 / $114.61 / $287.27	Professional		$74.09	$114.61	$287.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $38.94 / $97.45	Professional	26	$25.99	$38.94	$97.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.95 / $75.50 / $189.24	Professional	TC	$47.95	$75.50	$189.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $88.50 / $144.58	Professional		$52.22	$88.50	$144.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $24.51 / $40.04	Professional	26	$16.89	$24.51	$40.04
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.33 / $63.99 / $104.53	Professional	TC	$35.33	$63.99	$104.53