Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $40.74 / $66.07	Facility	26	$33.11	$40.74	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $131.83	Professional		$61.66	$77.62	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $75.86	Professional	26	$33.88	$44.67	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	26	$43.65	$43.65	$43.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $66.07 / $104.71	Professional		$37.15	$66.07	$104.71
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $117.49	Professional		$81.28	$81.28	$117.49
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $67.61 / $67.61	Professional	26	$39.81	$67.61	$67.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $46.77 / $66.07	Facility	26	$10.00	$46.77	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $154.88	Professional		$69.18	$93.33	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $57.54 / $93.33	Professional	26	$41.69	$57.54	$93.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $616.60 / $616.60	Professional		$489.78	$616.60	$616.60
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $331.13 / $331.13	Professional	26	$263.03	$331.13	$331.13
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $33.88 / $60.26	Facility	26	$26.92	$33.88	$60.26
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $81.28 / $144.54	Professional		$61.66	$81.28	$144.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $46.77 / $79.43	Professional	26	$34.67	$46.77	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.11 / $60.26	Professional		$27.54	$33.11	$60.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $74.13 / $151.36	Professional		$35.48	$74.13	$151.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $158.49	Professional		$70.79	$93.33	$158.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $87.10	Professional	26	$40.74	$56.23	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $74.13 / $120.23	Professional		$56.23	$74.13	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $46.77 / $75.86	Professional	26	$34.67	$46.77	$75.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $75.86 / $91.20	Professional		$72.44	$75.86	$91.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $50.12	Professional	26	$39.81	$41.69	$50.12