Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.39 / $7.01 / $11.12	Facility	26	$5.39	$7.01	$11.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $30.00 / $58.77	Professional		$21.73	$30.00	$58.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $7.76 / $12.99	Professional	26	$5.80	$7.76	$12.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.86 / $21.06 / $41.46	Professional	TC	$15.86	$21.06	$41.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.96 / $25.43 / $61.40	Professional		$23.96	$25.43	$61.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.56 / $9.78 / $15.48	Professional	26	$5.56	$9.78	$15.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $17.60 / $22.01	Professional	TC	$17.60	$17.60	$22.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.83 / $22.70 / $36.14	Professional		$6.83	$22.70	$36.14
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $31.45 / $40.99 / $56.75	Professional		$31.45	$40.99	$56.75
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $8.47 / $15.82	Professional	26	$7.86	$8.47	$15.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.01 / $34.29 / $60.41	Professional		$24.01	$34.29	$60.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.83 / $9.61 / $17.45	Professional	26	$6.83	$9.61	$17.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $24.88 / $44.77	Professional	TC	$17.00	$24.88	$44.77
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 $208.83 / $208.83 / $272.63	Professional		$208.83	$208.83	$272.63
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.04 / $66.04 / $67.73	Professional	26	$66.04	$66.04	$67.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $188.00 / $188.00 / $204.83	Professional	TC	$188.00	$188.00	$204.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $33.26 / $51.78 / $125.52	Professional		$33.26	$51.78	$125.52
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 $30.28 / $38.43 / $93.16	Professional	TC	$30.28	$38.43	$93.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.68 / $36.82 / $66.88	Professional		$12.68	$36.82	$66.88
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.93 / $38.03 / $84.12	Professional		$24.93	$38.03	$84.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $9.25 / $16.57	Professional	26	$6.98	$9.25	$16.57
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.02 / $24.67 / $43.28	Professional	TC	$17.02	$24.67	$43.28
United Facility/Professional Professional Modifier Low / Median / High Price $25.60 / $30.79 / $50.46	Professional		$25.60	$30.79	$50.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $8.57 / $14.67	Professional	26	$7.22	$8.57	$14.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.32 / $36.09	Professional	TC	$17.89	$22.32	$36.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $29.95 / $42.57	Professional		$26.78	$29.95	$42.57
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 $19.88 / $22.01 / $31.60	Professional	TC	$19.88	$22.01	$31.60