Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.61 / $7.29 / $11.29	Facility	26	$5.61	$7.29	$11.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.27 / $27.72 / $67.86	Professional		$21.27	$27.72	$67.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $8.14 / $19.38	Professional	26	$6.12	$8.14	$19.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.87 / $19.82 / $37.61	Professional	TC	$14.87	$19.82	$37.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.32 / $24.66 / $51.89	Professional		$20.32	$24.66	$51.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.44 / $16.12	Professional	26	$6.61	$8.44	$16.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.75 / $17.75 / $17.75	Professional	TC	$17.75	$17.75	$17.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $22.23 / $35.08	Professional		$7.24	$22.23	$35.08
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $41.61 / $58.10	Professional		$30.00	$41.61	$58.10
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $8.82 / $17.07	Professional	26	$8.18	$8.82	$17.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.61 / $31.35 / $58.37	Professional		$22.61	$31.35	$58.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $9.57 / $17.45	Professional	26	$6.74	$9.57	$17.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $21.68 / $40.79	Professional	TC	$15.59	$21.68	$40.79
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.44 / $100.00 / $100.00	Facility	26	$63.44	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $202.27 / $202.27 / $263.85	Professional		$202.27	$202.27	$263.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $111.75 / $111.75 / $111.75	Professional	26	$111.75	$111.75	$111.75
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $146.99 / $146.99 / $193.58	Professional	TC	$146.99	$146.99	$193.58
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $39.53 / $71.56	Professional		$15.00	$39.53	$71.56
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $13.88 / $33.64	Professional	26	$10.93	$13.88	$33.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.50 / $36.29 / $88.00	Professional	TC	$27.50	$36.29	$88.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.24 / $27.71 / $41.70	Professional		$10.24	$27.71	$41.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Providence Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $36.00 / $79.66	Professional		$23.03	$36.00	$79.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $9.31 / $16.61	Professional	26	$6.74	$9.31	$16.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $21.31 / $39.95	Professional	TC	$15.59	$21.31	$39.95
United Facility/Professional Professional Modifier Low / Median / High Price $24.26 / $29.49 / $49.66	Professional		$24.26	$29.49	$49.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $8.91 / $14.74	Professional	26	$7.34	$8.91	$14.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $20.58 / $34.10	Professional	TC	$16.48	$20.58	$34.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.95 / $29.05 / $41.26	Professional		$25.95	$29.05	$41.26
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $8.26 / $11.41	Professional	26	$7.18	$8.26	$11.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $20.78 / $29.85	Professional	TC	$18.78	$20.78	$29.85