Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.71 / $8.69 / $13.45	Facility	26	$6.71	$8.69	$13.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $35.70 / $70.86	Professional		$25.83	$35.70	$70.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $10.09 / $18.76	Professional	26	$7.22	$10.09	$18.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.13 / $24.44 / $47.26	Professional	TC	$18.13	$24.44	$47.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.45 / $29.40 / $37.00	Professional		$24.45	$29.40	$37.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $9.86 / $19.23	Professional	26	$6.90	$9.86	$19.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.05 / $20.05 / $25.06	Professional	TC	$20.05	$20.05	$25.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $26.74 / $41.75	Professional		$8.51	$26.74	$41.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $34.93 / $43.66 / $55.89	Professional		$34.93	$43.66	$55.89
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $9.76 / $10.55 / $24.33	Professional	26	$9.76	$10.55	$24.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.30 / $42.55 / $74.45	Professional		$29.30	$42.55	$74.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $13.19 / $24.72	Professional	26	$8.63	$13.19	$24.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $29.54 / $52.37	Professional	TC	$20.26	$29.54	$52.37
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 $262.00 / $262.00 / $316.64	Professional		$262.00	$262.00	$316.64
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.32 / $107.32 / $107.32	Professional	26	$107.32	$107.32	$107.32
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $233.18 / $249.00 / $249.00	Professional	TC	$233.18	$249.00	$249.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.55 / $60.31 / $93.60	Professional		$30.55	$60.31	$93.60
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.04 / $16.55 / $40.11	Professional	26	$13.04	$16.55	$40.11
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.47 / $43.76 / $106.08	Professional	TC	$34.47	$43.76	$106.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.46 / $42.51 / $78.56	Professional		$15.46	$42.51	$78.56
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.12 / $46.46 / $98.44	Professional		$30.12	$46.46	$98.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $12.38 / $23.24	Professional	26	$8.73	$12.38	$23.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.55 / $29.01 / $50.80	Professional	TC	$20.55	$29.01	$50.80
United Facility/Professional Professional Modifier Low / Median / High Price $30.12 / $37.97 / $63.19	Professional		$30.12	$37.97	$63.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.82 / $11.75 / $20.21	Professional	26	$9.82	$11.75	$20.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.77 / $26.47 / $42.98	Professional	TC	$21.77	$26.47	$42.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $34.93 / $49.61	Professional		$31.19	$34.93	$49.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $9.86 / $13.61	Professional	26	$8.56	$9.86	$13.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.63 / $25.06 / $36.00	Professional	TC	$22.63	$25.06	$36.00