Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.55 / $218.41 / $329.98	Professional		$195.55	$218.41	$329.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.43 / $41.17 / $105.08	Professional	26	$26.43	$41.17	$105.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.78 / $190.88 / $437.87	Professional	TC	$168.78	$190.88	$437.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.79 / $119.79 / $133.06	Professional		$119.79	$119.79	$133.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.04 / $20.29 / $69.28	Professional	26	$19.04	$20.29	$69.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $100.75 / $100.75 / $113.31	Professional	TC	$100.75	$100.75	$113.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.68 / $143.22 / $428.86	Professional		$51.68	$143.22	$428.86
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $60.65 / $239.50 / $402.21	Professional		$60.65	$239.50	$402.21
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $37.82 / $38.22 / $39.72	Professional	26	$37.82	$38.22	$39.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.58 / $177.45 / $522.50	Professional		$97.58	$177.45	$522.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.86 / $24.43 / $75.47	Professional	26	$19.86	$24.43	$75.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.01 / $153.97 / $445.41	Professional	TC	$76.01	$153.97	$445.41
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $97.99 / $199.50 / $199.50	Facility	26	$97.99	$199.50	$199.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,077.04 / $2,077.04 / $2,291.85	Professional		$2,077.04	$2,077.04	$2,291.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $267.88 / $267.88 / $320.70	Professional	26	$267.88	$267.88	$320.70
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,809.15 / $1,809.15 / $1,971.15	Professional	TC	$1,809.15	$1,809.15	$1,971.15
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $369.98 / $491.54	Professional		$144.00	$369.98	$491.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.93 / $58.71 / $95.17	Professional	26	$48.93	$58.71	$95.17
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $337.70 / $635.03	Professional	TC	$281.41	$337.70	$635.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $245.82 / $480.83	Professional		$42.50	$245.82	$480.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.58 / $231.59 / $772.39	Professional		$97.58	$231.59	$772.39
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.86 / $24.43 / $75.47	Professional	26	$19.86	$24.43	$75.47
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $76.01 / $151.15 / $454.32	Professional	TC	$76.01	$151.15	$454.32
United Facility/Professional Professional Modifier Low / Median / High Price $130.07 / $216.34 / $696.52	Professional		$130.07	$216.34	$696.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.68 / $28.65 / $92.38	Professional	26	$27.68	$28.65	$92.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.42 / $183.17 / $599.00	Professional	TC	$101.42	$183.17	$599.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $135.82 / $148.69 / $264.04	Professional		$135.82	$148.69	$264.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $21.19 / $39.42	Professional	26	$18.01	$21.19	$39.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $117.81 / $127.50 / $224.62	Professional	TC	$117.81	$127.50	$224.62