Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.15 / $94.95 / $149.36	Facility	26	$69.15	$94.95	$149.36
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $25.06 / $38.61 / $81.23	Facility	53	$25.06	$38.61	$81.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.46 / $268.66 / $443.47	Professional		$171.46	$268.66	$443.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.15 / $109.06 / $466.00	Professional	26	$69.15	$109.06	$466.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $536.26 / $536.26 / $536.26	Professional		$536.26	$536.26	$536.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.75 / $102.96 / $129.27	Professional	26	$95.75	$102.96	$129.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.52 / $173.97 / $321.02	Professional		$83.52	$173.97	$321.02
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $226.91 / $278.08 / $394.91	Professional		$226.91	$278.08	$394.91
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $98.40 / $104.08 / $104.08	Professional	26	$98.40	$104.08	$104.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.77 / $346.90 / $577.29	Professional		$248.77	$346.90	$577.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.20 / $145.09 / $231.21	Professional	26	$110.20	$145.09	$231.21
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $760.56 / $961.28 / $985.36	Facility	26	$760.56	$961.28	$985.36
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $97.84 / $243.44 / $243.44	Facility	53	$97.84	$243.44	$243.44
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,920.39 / $1,920.39 / $1,927.13	Professional		$1,920.39	$1,920.39	$1,927.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $834.53 / $1,030.27 / $1,030.27	Professional	26	$834.53	$1,030.27	$1,030.27
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $142.68 / $293.10 / $405.83	Professional		$142.68	$293.10	$405.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $126.15 / $154.41 / $187.71	Professional	26	$126.15	$154.41	$187.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $113.22 / $196.08 / $410.51	Professional		$113.22	$196.08	$410.51
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $249.48 / $354.66 / $613.36	Professional		$249.48	$354.66	$613.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $108.38 / $144.91 / $214.17	Professional	26	$108.38	$144.91	$214.17
United Facility/Professional Professional Modifier Low / Median / High Price $213.50 / $301.43 / $497.40	Professional		$213.50	$301.43	$497.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.36 / $118.76 / $208.80	Professional	26	$87.36	$118.76	$208.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $192.42 / $217.11 / $306.33	Professional		$192.42	$217.11	$306.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $86.13 / $99.44 / $139.22	Professional	26	$86.13	$99.44	$139.22