Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.39 / $6.88 / $9.92	Facility	26	$5.39	$6.88	$9.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $33.35 / $76.31	Professional		$25.20	$33.35	$76.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $7.82 / $18.57	Professional	26	$5.87	$7.82	$18.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $25.58 / $50.48	Professional	TC	$19.48	$25.58	$50.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.39 / $27.87 / $36.97	Professional		$24.39	$27.87	$36.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.56 / $7.94 / $15.48	Professional	26	$5.56	$7.94	$15.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $26.90 / $26.90	Professional	TC	$26.90	$26.90	$26.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.35 / $26.84 / $42.09	Professional		$7.35	$26.84	$42.09
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $42.00 / $69.68	Professional		$33.22	$42.00	$69.68
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $8.47 / $20.32	Professional	26	$7.86	$8.47	$20.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.76 / $36.71 / $69.33	Professional		$26.76	$36.71	$69.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $9.55 / $17.45	Professional	26	$6.71	$9.55	$17.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $27.30 / $52.48	Professional	TC	$20.17	$27.30	$52.48
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $245.68 / $245.68 / $317.85	Professional		$245.68	$245.68	$317.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.09 / $61.09 / $67.73	Professional	26	$61.09	$61.09	$67.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $192.57 / $192.57 / $250.13	Professional	TC	$192.57	$192.57	$250.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.84 / $60.31 / $86.81	Professional		$34.84	$60.31	$86.81
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.52 / $13.35 / $32.36	Professional	26	$10.52	$13.35	$32.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $46.96 / $113.84	Professional	TC	$37.00	$46.96	$113.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.17 / $35.76 / $60.90	Professional		$9.17	$35.76	$60.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.12 / $42.13 / $93.08	Professional		$27.12	$42.13	$93.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.82 / $9.25 / $16.57	Professional	26	$6.82	$9.25	$16.57
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $27.05 / $51.63	Professional	TC	$20.17	$27.05	$51.63
United Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $34.97 / $57.82	Professional		$28.70	$34.97	$57.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $8.57 / $14.44	Professional	26	$7.22	$8.57	$14.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $26.40 / $42.47	Professional	TC	$21.00	$26.40	$42.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $34.84 / $49.61	Professional		$31.19	$34.84	$49.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $7.94 / $10.96	Professional	26	$6.90	$7.94	$10.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.29 / $26.90 / $38.64	Professional	TC	$24.29	$26.90	$38.64