Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.49 / $126.33 / $280.33	Facility		$39.49	$126.33	$280.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.16 / $23.82 / $28.49	Facility	26	$20.16	$23.82	$28.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $74.83 / $149.00	Professional		$34.00	$74.83	$149.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $31.43 / $61.30	Professional	26	$23.24	$31.43	$61.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $209.18 / $326.11 / $334.86	Professional	50	$209.18	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.72 / $21.87 / $45.26	Professional	52	$16.72	$21.87	$45.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.71 / $23.55 / $71.90	Professional	TC	$13.71	$23.55	$71.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.05 / $44.05 / $44.05	Professional		$44.05	$44.05	$44.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.84 / $292.20 / $538.61	Facility		$118.84	$292.20	$538.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.83 / $37.47 / $63.66	Professional		$23.83	$37.47	$63.66
Baylor Scott & White Facility/Professional Facility Modifier Low / Median / High Price $53.57 / $162.04 / $263.98	Facility		$53.57	$162.04	$263.98
Christus Facility/Professional Facility Modifier Low / Median / High Price $29.80 / $29.80 / $46.75	Facility		$29.80	$29.80	$46.75
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $27.92 / $28.40 / $29.56	Professional	26	$27.92	$28.40	$29.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.77 / $51.77 / $52.57	Facility		$51.77	$51.77	$52.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $87.06 / $156.63	Professional		$45.05	$87.06	$156.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.88 / $37.75 / $60.78	Professional	26	$26.88	$37.75	$60.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $46.31 / $97.34	Professional	TC	$16.35	$46.31	$97.34
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $100.79 / $267.77 / $267.77	Facility		$100.79	$267.77	$267.77
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $68.52 / $149.91 / $149.91	Facility	26	$68.52	$149.91	$149.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $459.15 / $472.92 / $472.92	Professional		$459.15	$472.92	$472.92
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $188.73 / $188.73 / $239.70	Professional	26	$188.73	$188.73	$239.70
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $313.58 / $323.00 / $323.00	Professional	TC	$313.58	$323.00	$323.00
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $91.89 / $137.59	Facility		$42.00	$91.89	$137.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $50.17 / $69.78 / $84.83	Professional		$50.17	$69.78	$84.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.99 / $44.05 / $53.55	Professional	26	$35.99	$44.05	$53.55
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $25.73 / $31.29	Professional	TC	$21.03	$25.73	$31.29
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $32.51 / $44.48 / $713.51	Facility		$32.51	$44.48	$713.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.06 / $43.48 / $83.93	Professional		$21.06	$43.48	$83.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $92.91 / $141.78	Facility		$42.00	$92.91	$141.78
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.57 / $88.42 / $152.84	Professional		$45.57	$88.42	$152.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.34 / $37.86 / $57.80	Professional	26	$27.34	$37.86	$57.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $44.54 / $98.67	Professional	TC	$16.67	$44.54	$98.67
United Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $80.19 / $134.00	Professional		$53.99	$80.19	$134.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.05 / $32.04 / $50.18	Professional	26	$24.05	$32.04	$50.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $45.87 / $80.94	Professional	TC	$26.99	$45.87	$80.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.93 / $44.05 / $61.98	Professional		$38.93	$44.05	$61.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.57 / $28.16 / $39.42	Professional	26	$24.57	$28.16	$39.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.36 / $15.89 / $22.82	Professional	TC	$14.36	$15.89	$22.82