Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.46 / $168.93 / $236.51	Facility	26	$141.46	$168.93	$236.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.71 / $299.23 / $476.27	Professional		$255.71	$299.23	$476.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $156.71 / $187.88 / $264.16	Professional	26	$156.71	$187.88	$264.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.25 / $111.98 / $157.63	Professional	TC	$87.25	$111.98	$157.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $259.72 / $292.70 / $399.15	Professional		$259.72	$292.70	$399.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $168.36 / $202.87 / $234.62	Professional	26	$168.36	$202.87	$234.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.63 / $228.59 / $376.57	Professional		$145.63	$228.59	$376.57
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $276.62 / $332.63 / $492.29	Professional		$276.62	$332.63	$492.29
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $172.18 / $256.26 / $256.26	Professional	26	$172.18	$256.26	$256.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.75 / $371.86 / $577.71	Professional		$217.75	$371.86	$577.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $180.79 / $240.96 / $369.64	Professional	26	$180.79	$240.96	$369.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.97 / $143.21 / $222.43	Professional	TC	$99.97	$143.21	$222.43
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $425.11 / $910.58 / $910.58	Facility	26	$425.11	$910.58	$910.58
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,850.58 / $1,850.58 / $2,337.38	Professional		$1,850.58	$1,850.58	$2,337.38
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,166.03 / $1,166.03 / $1,480.73	Professional	26	$1,166.03	$1,166.03	$1,480.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $684.55 / $684.55 / $856.65	Professional	TC	$684.55	$684.55	$856.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $291.27 / $420.67 / $622.88	Professional		$291.27	$420.67	$622.88
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $207.93 / $271.20 / $329.70	Professional	26	$207.93	$271.20	$329.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.59 / $149.47 / $181.70	Professional	TC	$114.59	$149.47	$181.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $111.33 / $233.10 / $479.22	Professional		$111.33	$233.10	$479.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $224.87 / $398.43 / $706.15	Professional		$224.87	$398.43	$706.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $181.03 / $247.34 / $369.64	Professional	26	$181.03	$247.34	$369.64
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $102.85 / $146.51 / $222.20	Professional	TC	$102.85	$146.51	$222.20
United Facility/Professional Professional Modifier Low / Median / High Price $246.61 / $325.89 / $534.66	Professional		$246.61	$325.89	$534.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $150.97 / $204.25 / $326.70	Professional	26	$150.97	$204.25	$326.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.68 / $124.92 / $202.74	Professional	TC	$92.68	$124.92	$202.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.66 / $275.36 / $373.44	Professional		$234.66	$275.36	$373.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $151.29 / $177.94 / $240.75	Professional	26	$151.29	$177.94	$240.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $83.38 / $97.43 / $132.69	Professional	TC	$83.38	$97.43	$132.69