Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.19 / $104.28 / $145.32	Professional		$85.19	$104.28	$145.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.31 / $74.68 / $100.95	Professional	26	$62.31	$74.68	$100.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.69 / $30.31 / $38.85	Professional	TC	$19.69	$30.31	$38.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.84 / $102.35 / $157.79	Professional		$83.84	$102.35	$157.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.05 / $72.05 / $72.05	Professional	26	$72.05	$72.05	$72.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.59 / $26.59 / $26.59	Professional	TC	$26.59	$26.59	$26.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.32 / $76.84 / $86.73	Professional		$54.32	$76.84	$86.73
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $101.90 / $138.10 / $204.44	Professional		$101.90	$138.10	$204.44
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $71.37 / $73.52 / $73.52	Professional	26	$71.37	$73.52	$73.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.38 / $113.95 / $188.09	Professional		$87.38	$113.95	$188.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.29 / $87.61 / $148.29	Professional	26	$65.29	$87.61	$148.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $29.22 / $52.70	Professional	TC	$19.00	$29.22	$52.70
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $177.91 / $343.65 / $379.86	Facility	26	$177.91	$343.65	$379.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $702.18 / $702.18 / $855.00	Professional		$702.18	$702.18	$855.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $487.97 / $487.97 / $607.73	Professional	26	$487.97	$487.97	$607.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $214.27 / $214.27 / $247.28	Professional	TC	$214.27	$214.27	$247.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $80.77 / $126.96 / $182.83	Professional		$80.77	$126.96	$182.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.24 / $95.46 / $132.16	Professional	26	$82.24	$95.46	$132.16
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.52 / $36.58 / $50.65	Professional	TC	$31.52	$36.58	$50.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.94 / $76.81 / $146.59	Professional		$26.94	$76.81	$146.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.81 / $117.23 / $209.21	Professional		$87.81	$117.23	$209.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $65.29 / $87.61 / $147.09	Professional	26	$65.29	$87.61	$147.09
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $29.22 / $52.70	Professional	TC	$19.00	$29.22	$52.70
United Facility/Professional Professional Modifier Low / Median / High Price $77.58 / $93.25 / $142.02	Professional		$77.58	$93.25	$142.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.80 / $73.40 / $110.19	Professional	26	$60.80	$73.40	$110.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $22.20 / $32.29	Professional	TC	$16.64	$22.20	$32.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $86.69 / $98.64 / $138.10	Professional		$86.69	$98.64	$138.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $62.67 / $72.05 / $99.97	Professional	26	$62.67	$72.05	$99.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.02 / $26.59 / $37.22	Professional	TC	$24.02	$26.59	$37.22