Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $8.91 / $18.20	Facility	26	$7.94	$8.91	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $114.82	Professional		$33.11	$46.77	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.88 / $35.48	Professional	26	$8.91	$12.88	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $63.10	Professional	TC	$22.91	$31.62	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $67.61	Professional		$30.20	$38.90	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.75 / $19.95	Professional	26	$9.33	$11.75	$19.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $27.54 / $51.29	Professional	TC	$21.88	$27.54	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $34.67 / $50.12	Professional		$10.47	$34.67	$50.12
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $85.11	Professional		$43.65	$61.66	$85.11
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $28.18 / $28.18	Professional	26	$11.75	$28.18	$28.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $14.13 / $20.42	Facility	26	$3.02	$14.13	$20.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $93.33	Professional		$34.67	$48.98	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.45 / $28.84	Professional	26	$10.47	$14.45	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $67.61	Professional	TC	$23.99	$35.48	$67.61
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 $309.03 / $389.05 / $389.05	Professional		$309.03	$389.05	$389.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $100.00 / $100.00	Professional	26	$95.50	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $295.12	Professional	TC	$251.19	$295.12	$295.12
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.33 / $16.22	Facility	26	$7.94	$9.33	$16.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $53.70 / $112.20	Professional		$35.48	$53.70	$112.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $32.36	Professional	26	$9.33	$15.14	$32.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $74.13	Professional	TC	$25.12	$37.15	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $32.36 / $38.02	Professional		$10.47	$32.36	$38.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $128.82	Professional		$70.79	$89.13	$128.82
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $14.13 / $20.42	Facility	26	$3.02	$14.13	$20.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $104.71	Professional		$34.67	$48.98	$104.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.49 / $23.99	Professional	26	$10.47	$13.49	$23.99
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.11 / $60.26	Professional	TC	$23.99	$33.11	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $72.44	Professional		$37.15	$44.67	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $12.88 / $21.88	Professional	26	$10.72	$12.88	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $30.90 / $51.29	Professional	TC	$25.70	$30.90	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $46.77 / $56.23	Professional		$44.67	$46.77	$56.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.59 / $15.14	Professional	26	$12.02	$12.59	$15.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $34.67 / $40.74	Professional	TC	$32.36	$34.67	$40.74