Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $9.83 / $15.65	Facility	26	$7.59	$9.83	$15.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.22 / $39.31 / $78.05	Professional		$29.22	$39.31	$78.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $10.64 / $25.13	Professional	26	$8.14	$10.64	$25.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $27.71 / $51.40	Professional	TC	$21.03	$27.71	$51.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $32.38 / $82.98	Professional		$30.00	$32.38	$82.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $14.12 / $22.32	Professional	26	$9.16	$14.12	$22.32
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $23.23 / $23.23	Professional	TC	$23.23	$23.23	$23.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.61 / $30.76 / $47.84	Professional		$9.61	$30.76	$47.84
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $38.46 / $46.55 / $65.17	Professional		$38.46	$46.55	$65.17
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.33 / $11.92 / $26.11	Professional	26	$11.33	$11.92	$26.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $43.81 / $80.95	Professional		$31.57	$43.81	$80.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $13.68 / $24.89	Professional	26	$9.73	$13.68	$24.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.87 / $30.87 / $56.81	Professional	TC	$21.87	$30.87	$56.81
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $100.00 / $100.00	Facility	26	$34.36	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $282.36 / $282.36 / $366.83	Professional		$282.36	$282.36	$366.83
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $90.81 / $90.81 / $96.90	Professional	26	$90.81	$90.81	$96.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $211.00 / $211.00 / $269.93	Professional	TC	$211.00	$211.00	$269.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.96 / $69.91 / $99.75	Professional		$52.96	$69.91	$99.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.13 / $19.21 / $46.56	Professional	26	$15.13	$19.21	$46.56
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.95 / $50.70 / $122.92	Professional	TC	$39.95	$50.70	$122.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.23 / $39.11 / $75.90	Professional		$14.23	$39.11	$75.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.27 / $49.47 / $108.50	Professional		$32.27	$49.47	$108.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $13.46 / $23.90	Professional	26	$9.94	$13.46	$23.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.87 / $30.43 / $55.71	Professional	TC	$21.87	$30.43	$55.71
United Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $40.79 / $68.72	Professional		$34.15	$40.79	$68.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $12.34 / $22.09	Professional	26	$10.39	$12.34	$22.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.60 / $28.46 / $46.61	Professional	TC	$22.60	$28.46	$46.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $40.47 / $57.54	Professional		$36.15	$40.47	$57.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $11.45 / $15.82	Professional	26	$9.93	$11.45	$15.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.23 / $29.04 / $41.72	Professional	TC	$26.23	$29.04	$41.72