Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.87 / $53.55 / $96.92	Facility	26	$44.87	$53.55	$96.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $124.85 / $233.28	Professional		$94.02	$124.85	$233.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $59.52 / $90.87	Professional	26	$48.06	$59.52	$90.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.96 / $60.26 / $144.51	Professional	TC	$45.96	$60.26	$144.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.43 / $76.43 / $137.58	Professional		$76.43	$76.43	$137.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.01 / $56.01 / $95.82	Professional	26	$56.01	$56.01	$95.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $97.02 / $182.52	Professional		$52.58	$97.02	$182.52
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $109.19 / $109.19 / $109.19	Professional		$109.19	$109.19	$109.19
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $55.44 / $59.03 / $59.03	Professional	26	$55.44	$59.03	$59.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.84 / $177.69 / $318.27	Professional		$115.84	$177.69	$318.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.20 / $77.94 / $128.34	Professional	26	$58.20	$77.94	$128.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.58 / $90.65 / $187.30	Professional	TC	$56.58	$90.65	$187.30
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $139.35 / $352.88 / $352.88	Facility	26	$139.35	$352.88	$352.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,010.47 / $1,060.27 / $1,089.32	Professional		$1,010.47	$1,060.27	$1,089.32
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $369.36 / $369.36 / $471.98	Professional	26	$369.36	$369.36	$471.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $681.15 / $707.89 / $727.29	Professional	TC	$681.15	$707.89	$727.29
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.96 / $169.82 / $261.16	Professional		$62.96	$169.82	$261.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.78 / $91.09 / $131.74	Professional	26	$66.78	$91.09	$131.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.02 / $90.05 / $129.44	Professional	TC	$66.02	$90.05	$129.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.27 / $81.19 / $304.70	Professional		$63.27	$81.19	$304.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $115.84 / $183.04 / $311.12	Professional		$115.84	$183.04	$311.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.07 / $77.94 / $117.82	Professional	26	$58.07	$77.94	$117.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $56.62 / $88.28 / $185.10	Professional	TC	$56.62	$88.28	$185.10
United Facility/Professional Professional Modifier Low / Median / High Price $99.90 / $146.72 / $268.87	Professional		$99.90	$146.72	$268.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $67.25 / $107.37	Professional	26	$50.44	$67.25	$107.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.68 / $79.94 / $157.28	Professional	TC	$50.68	$79.94	$157.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.62 / $109.19 / $153.85	Professional		$96.62	$109.19	$153.85
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.59 / $56.01 / $78.41	Professional	26	$48.59	$56.01	$78.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $48.03 / $53.18 / $76.45	Professional	TC	$48.03	$53.18	$76.45