Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.92 / $274.32 / $590.66	Professional		$240.92	$274.32	$590.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $50.19 / $138.80	Professional	26	$38.84	$50.19	$138.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.04 / $219.26 / $443.86	Professional	TC	$157.04	$219.26	$443.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.99 / $189.42 / $350.00	Professional		$178.99	$189.42	$350.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $31.32 / $100.61	Professional	26	$29.82	$31.32	$100.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $149.16 / $149.16 / $199.93	Professional	TC	$149.16	$149.16	$199.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.11 / $187.12 / $560.27	Professional		$77.11	$187.12	$560.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $6.00 / $501.17 / $515.22	Professional		$6.00	$501.17	$515.22
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $58.35 / $59.01 / $61.30	Professional	26	$58.35	$59.01	$61.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.07 / $210.86 / $666.85	Professional		$102.07	$210.86	$666.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.65 / $35.43 / $114.92	Professional	26	$30.65	$35.43	$114.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $175.46 / $553.96	Professional	TC	$70.73	$175.46	$553.96
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $243.03 / $309.61 / $309.61	Facility	26	$243.03	$309.61	$309.61
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,575.76 / $2,575.76 / $3,260.25	Professional		$2,575.76	$2,575.76	$3,260.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $393.91 / $393.91 / $495.83	Professional	26	$393.91	$393.91	$495.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,181.85 / $2,181.85 / $2,764.35	Professional	TC	$2,181.85	$2,181.85	$2,764.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $434.34 / $564.29 / $753.36	Professional		$434.34	$564.29	$753.36
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.61 / $90.74 / $140.10	Professional	26	$75.61	$90.74	$140.10
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $394.63 / $473.55 / $766.00	Professional	TC	$394.63	$473.55	$766.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.63 / $346.48 / $690.93	Professional		$62.63	$346.48	$690.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $102.12 / $275.74 / $975.56	Professional		$102.12	$275.74	$975.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.65 / $35.43 / $112.89	Professional	26	$30.65	$35.43	$112.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $175.46 / $553.96	Professional	TC	$70.73	$175.46	$553.96
United Facility/Professional Professional Modifier Low / Median / High Price $135.99 / $252.10 / $823.56	Professional		$135.99	$252.10	$823.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.96 / $41.62 / $134.97	Professional	26	$39.96	$41.62	$134.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.37 / $210.38 / $688.58	Professional	TC	$94.37	$210.38	$688.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.59 / $204.34 / $375.90	Professional		$160.59	$204.34	$375.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.32 / $32.13 / $60.92	Professional	26	$26.32	$32.13	$60.92
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $134.27 / $172.21 / $314.98	Professional	TC	$134.27	$172.21	$314.98