Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.70 / $60.06 / $841.71	Facility		$50.70	$60.06	$841.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.04 / $16.72 / $20.56	Facility	26	$14.04	$16.72	$20.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $71.33 / $146.81	Professional		$54.18	$71.33	$146.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $18.32 / $25.14	Professional	26	$14.98	$18.32	$25.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.94 / $51.68 / $128.08	Professional	TC	$40.94	$51.68	$128.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.10 / $61.14 / $120.57	Professional		$60.10	$61.14	$120.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $17.39 / $17.39	Professional	26	$17.39	$17.39	$17.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.56 / $140.71 / $280.50	Facility		$62.56	$140.71	$280.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.32 / $48.31 / $90.03	Professional		$16.32	$48.31	$90.03
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $70.68 / $89.63	Professional		$64.20	$70.68	$89.63
Christus Facility/Professional Facility Modifier Low / Median / High Price $60.98 / $155.57 / $155.57	Facility		$60.98	$155.57	$155.57
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $16.97 / $25.20 / $25.20	Professional	26	$16.97	$25.20	$25.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.14 / $204.63 / $804.00	Facility		$90.14	$204.63	$804.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $101.82 / $249.85	Professional		$63.82	$101.82	$249.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.69 / $23.54 / $37.03	Professional	26	$17.69	$23.54	$37.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.91 / $74.61 / $211.49	Professional	TC	$45.91	$74.61	$211.49
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $213.52 / $353.50 / $353.50	Facility		$213.52	$353.50	$353.50
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.74 / $134.26 / $134.26	Facility	26	$50.74	$134.26	$134.26
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $611.90 / $803.55 / $803.55	Professional		$611.90	$803.55	$803.55
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $416.07 / $416.07 / $416.07	Professional	26	$416.07	$416.07	$416.07
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $567.25 / $578.59 / $578.59	Professional	TC	$567.25	$578.59	$578.59
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.06 / $77.69 / $162.82	Facility		$60.06	$77.69	$162.82
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $73.66 / $112.09 / $299.45	Professional		$73.66	$112.09	$299.45
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.49 / $26.73 / $36.86	Professional	26	$20.49	$26.73	$36.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.64 / $81.52 / $115.29	Professional	TC	$54.64	$81.52	$115.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $59.71 / $110.44	Professional		$19.34	$59.71	$110.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.06 / $78.08 / $164.15	Facility		$60.06	$78.08	$164.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.86 / $115.64 / $239.09	Professional		$67.86	$115.64	$239.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $24.19 / $37.01	Professional	26	$17.78	$24.19	$37.01
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $48.35 / $74.61 / $220.55	Professional	TC	$48.35	$74.61	$220.55
United Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $99.45 / $175.77	Professional		$57.67	$99.45	$175.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $20.09 / $32.13	Professional	26	$14.60	$20.09	$32.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.41 / $76.64 / $149.44	Professional	TC	$41.41	$76.64	$149.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.93 / $62.00 / $85.60	Professional		$52.93	$62.00	$85.60
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.91 / $17.55 / $23.75	Professional	26	$14.91	$17.55	$23.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.75 / $46.45 / $63.26	Professional	TC	$39.75	$46.45	$63.26