Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $204.17 / $302.00	Facility	26	$186.21	$204.17	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $954.99 / $1,621.81	Professional		$707.95	$954.99	$1,621.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $263.03 / $616.60	Professional	26	$186.21	$263.03	$616.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $275.42 / $323.59	Professional	26	$218.78	$275.42	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $630.96 / $1,071.52	Professional		$190.55	$630.96	$1,071.52
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,230.27 / $1,258.93	Professional		$812.83	$1,230.27	$1,258.93
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Professional	26	$223.87	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.01 / $1,202.26 / $1,737.80	Professional		$912.01	$1,202.26	$1,737.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $323.59 / $489.78	Professional	26	$245.47	$323.59	$489.78
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility	26	$2,089.30	$2,089.30	$2,089.30
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,025.60 / $7,244.36 / $7,244.36	Professional		$6,025.60	$7,244.36	$7,244.36
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,445.44 / $1,949.84 / $1,949.84	Professional	26	$1,445.44	$1,949.84	$1,949.84
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $204.17 / $302.00	Facility	26	$186.21	$204.17	$302.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,148.15 / $2,089.30	Professional		$758.58	$1,148.15	$2,089.30
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $302.00 / $501.19	Professional	26	$186.21	$302.00	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $630.96	Professional		$32.36	$33.11	$630.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $2,344.23 / $3,235.94	Professional		$831.76	$2,344.23	$3,235.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,202.26 / $1,737.80	Professional		$891.25	$1,202.26	$1,737.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $245.47 / $323.59 / $489.78	Professional	26	$245.47	$323.59	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $977.24 / $1,548.82	Professional		$724.44	$977.24	$1,548.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $275.42 / $426.58	Professional	26	$199.53	$275.42	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $891.25	Professional		$831.76	$831.76	$891.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $223.87 / $223.87 / $245.47	Professional	26	$223.87	$223.87	$245.47