Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.02 / $10.39 / $16.07	Facility	26	$8.02	$10.39	$16.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.78 / $43.10 / $83.57	Professional		$31.78	$43.10	$83.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $11.78 / $27.58	Professional	26	$8.63	$11.78	$27.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.01 / $30.35 / $58.86	Professional	TC	$23.01	$30.35	$58.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.63 / $34.60 / $88.66	Professional		$21.63	$34.60	$88.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $12.95 / $28.25	Professional	26	$9.19	$12.95	$28.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.18 / $25.18 / $31.48	Professional	TC	$25.18	$25.18	$31.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.74 / $32.90 / $52.71	Professional		$10.74	$32.90	$52.71
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $58.00 / $81.99	Professional		$45.55	$58.00	$81.99
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $12.59 / $30.80	Professional	26	$11.65	$12.59	$30.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $47.88 / $87.80	Professional		$34.08	$47.88	$87.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $14.21 / $26.06	Professional	26	$10.19	$14.21	$26.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $34.40 / $62.34	Professional	TC	$24.24	$34.40	$62.34
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 $306.22 / $306.22 / $392.03	Professional		$306.22	$306.22	$392.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.76 / $95.76 / $99.45	Professional	26	$95.76	$95.76	$99.45
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $250.00 / $250.00 / $292.58	Professional	TC	$250.00	$250.00	$292.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $47.58 / $74.73 / $108.13	Professional		$47.58	$74.73	$108.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.56 / $19.75 / $47.88	Professional	26	$15.56	$19.75	$47.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.32 / $54.98 / $133.28	Professional	TC	$43.32	$54.98	$133.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $81.59 / $129.19	Professional		$59.96	$81.59	$129.19
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $54.17 / $118.15	Professional		$35.24	$54.17	$118.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $13.85 / $25.21	Professional	26	$10.39	$13.85	$25.21
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.04 / $33.70 / $61.10	Professional	TC	$24.04	$33.70	$61.10
United Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $44.23 / $73.14	Professional		$37.25	$44.23	$73.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $13.02 / $21.94	Professional	26	$10.97	$13.02	$21.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.13 / $31.21 / $51.60	Professional	TC	$25.13	$31.21	$51.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $43.25 / $61.49	Professional		$38.65	$43.25	$61.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.22 / $11.77 / $16.25	Professional	26	$10.22	$11.77	$16.25
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.44 / $31.48 / $45.24	Professional	TC	$28.44	$31.48	$45.24