Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.91 / $23.49 / $46.03	Facility	26	$18.91	$23.49	$46.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $124.34 / $184.08	Professional		$101.65	$124.34	$184.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $26.20 / $47.17	Professional	26	$20.27	$26.20	$47.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $100.25 / $140.78	Professional	TC	$69.04	$100.25	$140.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $19.75 / $58.05	Professional	26	$19.75	$19.75	$58.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.36 / $95.16 / $200.89	Professional		$22.36	$95.16	$200.89
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $134.25 / $153.00 / $214.80	Professional		$134.25	$153.00	$214.80
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $33.36 / $35.56 / $35.56	Professional	26	$33.36	$35.56	$35.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Facility	26	$39.43	$39.43	$39.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.68 / $217.40 / $368.35	Professional		$147.68	$217.40	$368.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $36.72 / $62.50	Professional	26	$25.75	$36.72	$62.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.57 / $183.10 / $311.70	Professional	TC	$122.57	$183.10	$311.70
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $82.93 / $174.33 / $174.33	Facility	26	$82.93	$174.33	$174.33
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,219.73 / $1,341.64 / $1,341.64	Professional		$1,219.73	$1,341.64	$1,341.64
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $286.73 / $375.24 / $375.24	Professional	26	$286.73	$375.24	$375.24
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $936.06 / $1,090.58 / $1,120.47	Professional	TC	$936.06	$1,090.58	$1,120.47
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $134.25 / $234.35 / $367.00	Professional		$134.25	$234.35	$367.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $51.44 / $63.78	Professional	26	$40.22	$51.44	$63.78
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $137.16 / $182.93 / $310.66	Professional	TC	$137.16	$182.93	$310.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.84 / $153.19 / $258.33	Professional		$37.84	$153.19	$258.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $39.43	Facility	26	$39.43	$39.43	$39.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $151.90 / $220.48 / $403.84	Professional		$151.90	$220.48	$403.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.01 / $36.58 / $58.04	Professional	26	$26.01	$36.58	$58.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $122.57 / $182.37 / $308.89	Professional	TC	$122.57	$182.37	$308.89
United Facility/Professional Professional Modifier Low / Median / High Price $132.52 / $190.40 / $324.41	Professional		$132.52	$190.40	$324.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.70 / $29.78 / $51.03	Professional	26	$21.70	$29.78	$51.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.86 / $158.97 / $270.88	Professional	TC	$110.86	$158.97	$270.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.09 / $134.25 / $191.07	Professional		$120.09	$134.25	$191.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $33.69 / $47.17	Professional	26	$29.27	$33.69	$47.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $90.83 / $100.56 / $144.56	Professional	TC	$90.83	$100.56	$144.56