Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.49 / $116.23 / $153.66	Professional		$94.49	$116.23	$153.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $14.24 / $19.26	Professional	26	$11.73	$14.24	$19.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.56 / $102.09 / $132.91	Professional	TC	$79.56	$102.09	$132.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.55 / $121.55 / $154.76	Professional		$121.55	$121.55	$154.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.44 / $42.12 / $101.46	Professional		$10.44	$42.12	$101.46
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $121.55 / $154.68 / $213.46	Professional		$121.55	$154.68	$213.46
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $13.83 / $14.48 / $14.48	Professional	26	$13.83	$14.48	$14.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $130.06 / $197.84	Professional		$89.13	$130.06	$197.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.53 / $16.75 / $29.40	Professional	26	$12.53	$16.75	$29.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.69 / $114.46 / $177.48	Professional	TC	$76.69	$114.46	$177.48
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $42.29 / $100.00	Facility	26	$34.29	$42.29	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $800.25 / $800.25 / $1,116.59	Professional		$800.25	$800.25	$1,116.59
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $135.38 / $135.38 / $135.38	Professional	26	$135.38	$135.38	$135.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $706.26 / $706.26 / $998.10	Professional	TC	$706.26	$706.26	$998.10
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $125.25 / $153.71 / $230.56	Professional		$125.25	$153.71	$230.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.94 / $18.50 / $25.61	Professional	26	$15.94	$18.50	$25.61
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $127.52 / $143.46 / $204.95	Professional	TC	$127.52	$143.46	$204.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.96 / $115.35 / $220.34	Professional		$13.96	$115.35	$220.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.76 / $134.74 / $233.19	Professional		$86.76	$134.74	$233.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.51 / $16.75 / $28.74	Professional	26	$12.51	$16.75	$28.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.91 / $115.12 / $186.63	Professional	TC	$75.91	$115.12	$186.63
United Facility/Professional Professional Modifier Low / Median / High Price $76.65 / $94.33 / $141.65	Professional		$76.65	$94.33	$141.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.61 / $13.72 / $21.17	Professional	26	$11.61	$13.72	$21.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.09 / $82.48 / $120.46	Professional	TC	$65.09	$82.48	$120.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $121.55 / $170.17	Professional		$82.40	$121.55	$170.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $13.96 / $19.35	Professional	26	$12.14	$13.96	$19.35
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $97.18 / $107.59 / $150.63	Professional	TC	$97.18	$107.59	$150.63