Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.37 / $77.62 / $178.77	Professional		$68.37	$77.62	$178.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $22.82 / $45.22	Professional	26	$18.30	$22.82	$45.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.89 / $54.16 / $133.44	Professional	TC	$48.89	$54.16	$133.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.53 / $60.53 / $63.85	Professional		$60.53	$60.53	$63.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Professional	26	$16.25	$16.25	$16.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.01 / $57.67 / $172.68	Professional		$40.01	$57.67	$172.68
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $113.80 / $169.48 / $193.46	Professional		$113.80	$169.48	$193.46
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.79 / $31.19 / $32.47	Professional	26	$30.79	$31.19	$32.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $64.53 / $210.69	Professional		$35.15	$64.53	$210.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $17.36 / $58.09	Professional	26	$12.29	$17.36	$58.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $48.25 / $150.35	Professional	TC	$23.17	$48.25	$150.35
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $80.39 / $164.49 / $164.49	Facility	26	$80.39	$164.49	$164.49
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $730.19 / $730.19 / $1,094.09	Professional		$730.19	$730.19	$1,094.09
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.12 / $200.25 / $264.08	Professional	26	$199.12	$200.25	$264.08
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $531.07 / $531.07 / $830.03	Professional	TC	$531.07	$531.07	$830.03
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $148.74 / $190.20 / $257.36	Professional		$148.74	$190.20	$257.36
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $48.03 / $70.81	Professional	26	$40.03	$48.03	$70.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $118.48 / $142.16 / $186.54	Professional	TC	$118.48	$142.16	$186.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $106.07 / $223.46	Professional		$32.72	$106.07	$223.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.17 / $84.71 / $283.95	Professional		$35.17	$84.71	$283.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.01 / $17.36 / $58.09	Professional	26	$12.01	$17.36	$58.09
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $48.13 / $145.94	Professional	TC	$23.17	$48.13	$145.94
United Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $69.94 / $233.14	Professional		$46.84	$69.94	$233.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $20.83 / $67.84	Professional	26	$15.92	$20.83	$67.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.92 / $50.15 / $165.30	Professional	TC	$30.92	$50.15	$165.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $66.38 / $126.78	Professional		$44.64	$66.38	$126.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $16.84 / $32.22	Professional	26	$13.23	$16.84	$32.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.10 / $49.54 / $94.55	Professional	TC	$31.10	$49.54	$94.55