Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $256.20 / $271.20 / $275.39	Facility		$256.20	$271.20	$275.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $60.77 / $107.33	Professional		$43.19	$60.77	$107.33
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.36 / $66.36 / $81.93	Professional	25	$66.36	$66.36	$81.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $25.02 / $38.59	Professional	26	$18.76	$25.02	$38.59
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.60 / $28.14 / $43.09	Professional	52	$21.60	$28.14	$43.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.43 / $32.58 / $60.08	Professional	TC	$24.43	$32.58	$60.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.86 / $58.65 / $75.73	Professional		$49.86	$58.65	$75.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.69 / $98.12 / $380.63	Facility		$68.69	$98.12	$380.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $44.12 / $49.79	Professional		$18.73	$44.12	$49.79
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $61.16 / $70.77 / $99.43	Professional		$61.16	$70.77	$99.43
Christus Facility/Professional Facility Modifier Low / Median / High Price $58.43 / $61.33 / $61.65	Facility		$58.43	$61.33	$61.65
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $24.81 / $37.15 / $37.15	Professional	26	$24.81	$37.15	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.03 / $73.22 / $134.88	Professional		$51.03	$73.22	$134.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $30.17 / $53.29	Professional	26	$22.02	$30.17	$53.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $42.74 / $80.47	Professional	TC	$29.25	$42.74	$80.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $129.86 / $286.08 / $333.50	Facility		$129.86	$286.08	$333.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $61.29 / $102.04 / $152.15	Facility	26	$61.29	$102.04	$152.15
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $396.63 / $403.38 / $524.78	Professional		$396.63	$403.38	$524.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $167.21 / $167.21 / $212.40	Professional	26	$167.21	$167.21	$212.40
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.11 / $264.83 / $312.38	Professional	TC	$257.11	$264.83	$312.38
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $47.38 / $68.00 / $116.62	Facility		$47.38	$68.00	$116.62
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $71.70 / $110.03	Professional		$52.00	$71.70	$110.03
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.62 / $34.49 / $48.03	Professional	26	$28.62	$34.49	$48.03
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.85 / $46.25 / $64.04	Professional	TC	$39.85	$46.25	$64.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.04 / $61.27 / $126.24	Professional		$30.04	$61.27	$126.24
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.96 / $68.16 / $116.61	Facility		$45.96	$68.16	$116.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.30 / $75.31 / $134.24	Professional		$52.30	$75.31	$134.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $30.27 / $52.37	Professional	26	$22.02	$30.27	$52.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $42.92 / $80.00	Professional	TC	$29.25	$42.92	$80.00
United Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $64.23 / $104.22	Professional		$48.18	$64.23	$104.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $24.67 / $36.34	Professional	26	$20.68	$24.67	$36.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.07 / $36.78 / $68.14	Professional	TC	$27.07	$36.78	$68.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.17 / $58.65 / $62.00	Professional		$52.17	$58.65	$62.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.81 / $25.03 / $34.78	Professional	26	$21.81	$25.03	$34.78
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.37 / $33.61 / $47.07	Professional	TC	$30.37	$33.61	$47.07