Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.02 / $352.63 / $873.92	Professional		$237.02	$352.63	$873.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.51 / $152.63 / $256.06	Professional	26	$100.51	$152.63	$256.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.21 / $177.85 / $502.33	Professional	TC	$122.21	$177.85	$502.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.11 / $341.39 / $606.04	Professional		$174.11	$341.39	$606.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.06 / $164.11 / $228.62	Professional	26	$82.06	$164.11	$228.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $88.64 / $88.64 / $88.64	Professional	TC	$88.64	$88.64	$88.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.61 / $262.43 / $308.74	Professional		$148.61	$262.43	$308.74
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $341.39 / $428.51 / $690.27	Professional		$341.39	$428.51	$690.27
Christus Facility/Professional Facility Modifier Low / Median / High Price $170.95 / $339.57 / $346.06	Facility		$170.95	$339.57	$346.06
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $175.01 / $180.54 / $189.64	Facility	TC	$175.01	$180.54	$189.64
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $164.57 / $165.51 / $169.53	Professional	26	$164.57	$165.51	$169.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $845.83 / $2,185.65 / $2,185.65	Facility		$845.83	$2,185.65	$2,185.65
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $276.06 / $858.66 / $858.66	Facility	26	$276.06	$858.66	$858.66
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $315.77 / $1,452.72 / $1,452.72	Facility	TC	$315.77	$1,452.72	$1,452.72
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $5,718.36 / $5,718.36 / $5,718.36	Professional		$5,718.36	$5,718.36	$5,718.36
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1,098.38 / $1,098.38 / $1,377.38	Professional	26	$1,098.38	$1,098.38	$1,377.38
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,767.92 / $2,229.25 / $2,229.25	Professional	TC	$1,767.92	$2,229.25	$2,229.25
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $304.33 / $442.15 / $970.49	Facility		$304.33	$442.15	$970.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $415.85 / $519.84 / $659.41	Professional		$415.85	$519.84	$659.41
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $208.64 / $250.37 / $310.45	Professional	26	$208.64	$250.37	$310.45
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $234.51 / $281.42 / $348.95	Professional	TC	$234.51	$281.42	$348.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $318.99 / $673.78	Professional		$171.00	$318.99	$673.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $304.33 / $443.81 / $973.14	Facility		$304.33	$443.81	$973.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $930.85	Professional		$326.16	$326.16	$930.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
United Facility/Professional Professional Modifier Low / Median / High Price $208.74 / $347.90 / $841.92	Professional		$208.74	$347.90	$841.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.74 / $113.87 / $367.85	Professional	26	$94.74	$113.87	$367.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.44 / $211.12 / $438.48	Professional	TC	$97.44	$211.12	$438.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.81 / $208.20 / $355.04	Professional		$173.81	$208.20	$355.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.62 / $89.16 / $167.93	Professional	26	$61.62	$89.16	$167.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $98.87 / $146.57 / $187.11	Professional	TC	$98.87	$146.57	$187.11