Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $371.54	Professional		$194.98	$234.42	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.90 / $104.71	Professional	26	$25.70	$38.90	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $199.53 / $354.81	Professional	TC	$151.36	$199.53	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $173.78	Professional		$131.83	$131.83	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $40.74 / $44.67	Professional	26	$20.42	$40.74	$44.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $74.13 / $371.54	Professional		$27.54	$74.13	$371.54
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $316.23 / $467.74	Professional		$64.57	$316.23	$467.74
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.90 / $38.90	Professional	26	$38.02	$38.90	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $524.81	Professional		$97.72	$177.83	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.12 / $77.62	Professional	26	$19.95	$25.12	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $154.88 / $457.09	Professional	TC	$75.86	$154.88	$457.09
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,089.30 / $2,290.87 / $2,290.87	Professional		$2,089.30	$2,290.87	$2,290.87
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $323.59 / $323.59	Professional	26	$269.15	$323.59	$323.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,819.70 / $1,949.84 / $1,949.84	Professional	TC	$1,819.70	$1,949.84	$1,949.84
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $309.03 / $501.19	Professional		$194.98	$309.03	$501.19
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $45.71 / $95.50	Professional	26	$25.70	$45.71	$95.50
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $263.03 / $436.52	Professional	TC	$169.82	$263.03	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $229.09	Professional		$32.36	$33.11	$229.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $245.47 / $537.03	Professional		$41.69	$245.47	$537.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $602.56	Professional		$97.72	$177.83	$602.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $75.86	Professional	26	$19.95	$23.99	$75.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $154.88 / $457.09	Professional	TC	$75.86	$154.88	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $208.93 / $691.83	Professional		$128.82	$208.93	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $28.84 / $93.33	Professional	26	$27.54	$28.84	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $181.97 / $602.56	Professional	TC	$102.33	$181.97	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $263.03	Professional		$134.90	$134.90	$263.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $18.20 / $39.81	Professional	26	$18.20	$18.20	$39.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $117.49 / $223.87	Professional	TC	$117.49	$117.49	$223.87