Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.91 / $36.38 / $57.82	Facility	26	$28.91	$36.38	$57.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.07 / $206.08 / $498.26	Professional		$156.07	$206.08	$498.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $37.54 / $87.08	Professional	26	$28.37	$37.54	$87.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.99 / $162.49 / $272.75	Professional	TC	$124.99	$162.49	$272.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.23 / $173.18 / $220.56	Professional		$121.23	$173.18	$220.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $35.64 / $60.14	Professional	26	$27.64	$35.64	$60.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $110.03 / $110.03 / $165.05	Professional	TC	$110.03	$110.03	$165.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.45 / $135.91 / $260.54	Professional		$32.45	$135.91	$260.54
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $147.19 / $195.16 / $346.24	Professional		$147.19	$195.16	$346.24
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.28 / $37.51 / $37.51	Professional	26	$35.28	$37.51	$37.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.26 / $262.98 / $435.57	Professional		$181.26	$262.98	$435.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $44.82 / $73.03	Professional	26	$32.26	$44.82	$73.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.83 / $215.73 / $372.43	Professional	TC	$147.83	$215.73	$372.43
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $87.82 / $189.47 / $210.00	Facility	26	$87.82	$189.47	$210.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,580.85 / $1,582.03 / $1,625.38	Professional		$1,580.85	$1,582.03	$1,625.38
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $422.69 / $422.69 / $422.69	Professional	26	$422.69	$422.69	$422.69
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,276.50 / $1,414.75 / $1,453.51	Professional	TC	$1,276.50	$1,414.75	$1,453.51
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.49 / $237.90 / $410.30	Professional		$47.49	$237.90	$410.30
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.50 / $57.97 / $86.81	Professional	26	$42.50	$57.97	$86.81
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.74 / $232.90 / $351.78	Professional	TC	$170.74	$232.90	$351.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.07 / $174.44 / $294.89	Professional		$40.07	$174.44	$294.89
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $182.05 / $270.66 / $463.29	Professional		$182.05	$270.66	$463.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $44.82 / $68.22	Professional	26	$32.26	$44.82	$68.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $149.35 / $215.53 / $367.99	Professional	TC	$149.35	$215.53	$367.99
United Facility/Professional Professional Modifier Low / Median / High Price $162.84 / $234.08 / $397.88	Professional		$162.84	$234.08	$397.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $40.78 / $64.43	Professional	26	$29.02	$40.78	$64.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.32 / $189.22 / $324.00	Professional	TC	$132.32	$189.22	$324.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $155.15 / $173.18 / $246.75	Professional		$155.15	$173.18	$246.75
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $35.64 / $49.90	Professional	26	$30.92	$35.64	$49.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $124.23 / $137.54 / $197.71	Professional	TC	$124.23	$137.54	$197.71