Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.46 / $7.94 / $14.13	Facility	26	$6.46	$7.94	$14.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $30.20 / $56.23	Professional		$21.88	$30.20	$56.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.12 / $21.38	Professional	26	$7.08	$9.12	$21.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.89 / $38.90	Professional	TC	$15.14	$20.89	$38.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $31.62 / $46.77	Professional		$20.89	$31.62	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.76 / $21.88	Professional	26	$7.41	$7.76	$21.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	TC	$16.22	$16.22	$16.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $23.99 / $33.88	Professional		$8.13	$23.99	$33.88
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $37.15 / $50.12	Professional		$29.51	$37.15	$50.12
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.33 / $10.00	Professional	26	$9.12	$9.33	$10.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.34 / $10.96 / $15.85	Facility	26	$2.34	$10.96	$15.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $34.67 / $64.57	Professional		$24.55	$34.67	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $22.39	Professional	26	$7.94	$11.22	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $23.99 / $45.71	Professional	TC	$16.22	$23.99	$45.71
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $269.15	Professional		$208.93	$269.15	$269.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $79.43 / $79.43	Professional	26	$77.62	$79.43	$79.43
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $194.98	Professional	TC	$190.55	$190.55	$194.98
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $7.08 / $14.45	Facility	26	$6.03	$7.08	$14.45
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.88 / $74.13	Professional		$22.91	$33.88	$74.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $25.70	Professional	26	$7.08	$10.96	$25.70
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.44 / $48.98	Professional	TC	$15.14	$23.44	$48.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $32.36 / $33.11	Professional		$7.94	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $87.10	Professional		$47.86	$63.10	$87.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.34 / $10.96 / $15.85	Facility	26	$2.34	$10.96	$15.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $34.67 / $70.79	Professional		$24.55	$34.67	$70.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $18.20	Professional	26	$7.94	$10.47	$18.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.39 / $39.81	Professional	TC	$15.85	$22.39	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.90 / $51.29	Professional		$25.70	$30.90	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $16.60	Professional	26	$8.32	$10.00	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $20.89 / $33.88	Professional	TC	$16.98	$20.89	$33.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $31.62 / $38.02	Professional		$30.20	$31.62	$38.02
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $9.77 / $11.75	Professional	26	$9.33	$9.77	$11.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $21.88 / $26.30	Professional	TC	$20.89	$21.88	$26.30