Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.04 / $43.46 / $73.55	Facility	26	$34.04	$43.46	$73.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.64 / $122.34 / $240.02	Professional		$81.64	$122.34	$240.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $52.98 / $100.83	Professional	26	$39.93	$52.98	$100.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.11 / $52.38 / $103.75	Professional	52	$39.11	$52.38	$103.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.03 / $58.32 / $138.75	Professional	TC	$40.03	$58.32	$138.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.39 / $93.55 / $160.12	Professional		$83.39	$93.55	$160.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.13 / $41.08 / $61.22	Professional	26	$37.13	$41.08	$61.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.02 / $51.02 / $56.37	Professional	TC	$51.02	$51.02	$56.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.53 / $67.39 / $121.25	Professional		$34.53	$67.39	$121.25
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $93.72 / $116.57 / $165.89	Professional		$93.72	$116.57	$165.89
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $61.09 / $61.09	Professional	26	$40.65	$61.09	$61.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.59 / $180.44 / $340.87	Professional		$97.59	$180.44	$340.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.38 / $69.53 / $127.77	Professional	26	$44.38	$69.53	$127.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.85 / $105.13 / $211.22	Professional	TC	$51.85	$105.13	$211.22
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $127.00 / $333.99 / $333.99	Facility	26	$127.00	$333.99	$333.99
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,000.00 / $3,000.00 / $3,000.00	Professional		$3,000.00	$3,000.00	$3,000.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $870.13 / $870.13 / $870.13	Professional	26	$870.13	$870.13	$870.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $870.13 / $870.13 / $870.13	Professional	TC	$870.13	$870.13	$870.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $89.67 / $142.53 / $334.18	Professional		$89.67	$142.53	$334.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.95 / $63.85 / $77.62	Professional	26	$48.95	$63.85	$77.62
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.33 / $73.03 / $95.66	Professional	TC	$60.33	$73.03	$95.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $50.41 / $89.72 / $186.31	Professional		$50.41	$89.72	$186.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.87 / $188.42 / $330.02	Professional		$103.87	$188.42	$330.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $67.83 / $135.86	Professional	26	$46.15	$67.83	$135.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $54.25 / $104.44 / $215.39	Professional	TC	$54.25	$104.44	$215.39
United Facility/Professional Professional Modifier Low / Median / High Price $101.24 / $166.74 / $291.41	Professional		$101.24	$166.74	$291.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.27 / $59.84 / $105.32	Professional	26	$39.27	$59.84	$105.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.68 / $99.76 / $171.41	Professional	TC	$61.68	$99.76	$171.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.51 / $93.21 / $126.52	Professional		$79.51	$93.21	$126.52
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $41.94 / $56.71	Professional	26	$35.61	$41.94	$56.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $43.89 / $51.27 / $69.81	Professional	TC	$43.89	$51.27	$69.81