Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.39 / $41.13 / $50.60	Facility	26	$34.39	$41.13	$50.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.19 / $348.04 / $488.45	Professional		$282.19	$348.04	$488.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $143.87 / $176.18 / $239.68	Professional	52	$143.87	$176.18	$239.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.80 / $303.33 / $426.55	Professional	TC	$247.80	$303.33	$426.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $258.07 / $481.44	Professional		$36.29	$258.07	$481.44
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $363.61 / $480.12 / $634.44	Professional		$363.61	$480.12	$634.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.00 / $434.78 / $680.68	Professional		$291.00	$434.78	$680.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.10 / $385.56 / $597.74	Professional	TC	$285.10	$385.56	$597.74
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $102.98 / $220.83 / $220.83	Facility	26	$102.98	$220.83	$220.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,332.00 / $2,332.00 / $3,148.13	Professional		$2,332.00	$2,332.00	$3,148.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,048.28 / $2,048.28 / $2,788.20	Professional	TC	$2,048.28	$2,048.28	$2,788.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $240.11 / $608.22 / $1,489.51	Professional		$240.11	$608.22	$1,489.51
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $373.35 / $486.98 / $592.02	Professional	TC	$373.35	$486.98	$592.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $366.04 / $642.84	Professional		$47.54	$366.04	$642.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $303.98 / $470.35 / $869.30	Professional		$303.98	$470.35	$869.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $285.38 / $392.36 / $592.65	Professional	TC	$285.38	$392.36	$592.65
United Facility/Professional Professional Modifier Low / Median / High Price $267.43 / $369.74 / $593.54	Professional		$267.43	$369.74	$593.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.56 / $315.27 / $505.04	Professional	TC	$234.56	$315.27	$505.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $308.37 / $360.70 / $490.87	Professional		$308.37	$360.70	$490.87
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $271.64 / $317.52 / $432.47	Professional	TC	$271.64	$317.52	$432.47