Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.37 / $9.55 / $14.61	Facility	26	$7.37	$9.55	$14.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $48.84 / $118.35	Professional		$35.79	$48.84	$118.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.69 / $10.63 / $21.01	Professional	26	$7.69	$10.63	$21.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.63 / $36.38 / $67.63	Professional	TC	$27.63	$36.38	$67.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $39.22 / $100.49	Professional		$38.26	$39.22	$100.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $10.82 / $17.85	Professional	26	$8.46	$10.82	$17.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.56 / $30.56 / $30.56	Professional	TC	$30.56	$30.56	$30.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.21 / $37.11 / $58.60	Professional		$10.21	$37.11	$58.60
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $49.02 / $56.00	Professional		$40.00	$49.02	$56.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.71 / $11.58 / $31.77	Professional	26	$10.71	$11.58	$31.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $13.10 / $13.10	Facility	26	$13.10	$13.10	$13.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $53.16 / $98.67	Professional		$38.26	$53.16	$98.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $13.37 / $24.06	Professional	26	$9.41	$13.37	$24.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.27 / $41.10 / $74.76	Professional	TC	$29.27	$41.10	$74.76
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 $345.31 / $345.31 / $446.25	Professional		$345.31	$345.31	$446.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $142.00 / $142.00 / $142.00	Professional	26	$142.00	$142.00	$142.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.83 / $272.83 / $354.75	Professional	TC	$272.83	$272.83	$354.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $64.29 / $84.86 / $205.72	Professional		$64.29	$84.86	$205.72
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $19.64 / $77.15	Professional	26	$14.30	$19.64	$77.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.56 / $66.70 / $161.72	Professional	TC	$52.56	$66.70	$161.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.79 / $52.34 / $93.50	Professional		$13.79	$52.34	$93.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $13.10 / $13.10	Facility	26	$13.10	$13.10	$13.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.07 / $60.54 / $133.16	Professional		$39.07	$60.54	$133.16
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.56 / $13.05 / $23.22	Professional	26	$9.56	$13.05	$23.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.14 / $40.22 / $73.23	Professional	TC	$29.14	$40.22	$73.23
United Facility/Professional Professional Modifier Low / Median / High Price $40.70 / $49.71 / $82.20	Professional		$40.70	$49.71	$82.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $12.12 / $20.41	Professional	26	$10.10	$12.12	$20.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.69 / $37.71 / $61.35	Professional	TC	$30.69	$37.71	$61.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $49.02 / $69.84	Professional		$43.89	$49.02	$69.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.39 / $10.82 / $14.93	Professional	26	$9.39	$10.82	$14.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.51 / $38.21 / $54.90	Professional	TC	$34.51	$38.21	$54.90