Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.18 / $51.64 / $72.33	Facility	26	$43.18	$51.64	$72.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $424.11 / $639.32	Professional		$338.67	$424.11	$639.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.99 / $57.27 / $140.08	Professional	26	$47.99	$57.27	$140.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $368.11 / $529.23	Professional	TC	$287.33	$368.11	$529.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $383.99 / $415.47 / $540.11	Professional		$383.99	$415.47	$540.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.96 / $54.23 / $71.08	Professional	26	$48.96	$54.23	$71.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $362.82 / $362.82 / $362.82	Professional	TC	$362.82	$362.82	$362.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.17 / $314.76 / $587.20	Professional		$44.17	$314.76	$587.20
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $178.00 / $498.56 / $679.14	Professional		$178.00	$498.56	$679.14
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $52.16 / $78.29 / $78.29	Professional	26	$52.16	$78.29	$78.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.57 / $503.26 / $831.62	Professional		$277.57	$503.26	$831.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.71 / $72.68 / $111.22	Professional	26	$54.71	$72.68	$111.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.52 / $442.05 / $731.99	Professional	TC	$261.52	$442.05	$731.99
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $128.97 / $276.20 / $276.20	Facility	26	$128.97	$276.20	$276.20
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,879.21 / $2,879.21 / $3,811.50	Professional		$2,879.21	$2,879.21	$3,811.50
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $356.25 / $356.25 / $447.83	Professional	26	$356.25	$356.25	$447.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,522.94 / $2,522.94 / $3,363.60	Professional	TC	$2,522.94	$2,522.94	$3,363.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $73.41 / $513.36 / $870.48	Professional		$73.41	$513.36	$870.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.99 / $82.16 / $99.88	Professional	26	$62.99	$82.16	$99.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $450.37 / $587.44 / $714.15	Professional	TC	$450.37	$587.44	$714.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.55 / $457.02 / $830.94	Professional		$60.55	$457.02	$830.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $367.24 / $578.49 / $1,062.14	Professional		$367.24	$578.49	$1,062.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $55.05 / $75.01 / $111.22	Professional	26	$55.05	$75.01	$111.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $285.64 / $456.36 / $725.64	Professional	TC	$285.64	$456.36	$725.64
United Facility/Professional Professional Modifier Low / Median / High Price $287.87 / $440.29 / $684.88	Professional		$287.87	$440.29	$684.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.87 / $62.53 / $99.93	Professional	26	$45.87	$62.53	$99.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $231.28 / $377.73 / $582.13	Professional	TC	$231.28	$377.73	$582.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $373.52 / $436.95 / $594.63	Professional		$373.52	$436.95	$594.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.83 / $53.92 / $72.95	Professional	26	$45.83	$53.92	$72.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $327.69 / $383.03 / $521.67	Professional	TC	$327.69	$383.03	$521.67