Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.67 / $72.93 / $86.87	Facility	26	$46.67	$72.93	$86.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.13 / $353.27 / $603.00	Professional		$208.13	$353.27	$603.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.15 / $86.87 / $189.00	Professional	26	$53.15	$86.87	$189.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $253.29 / $433.00	Professional	TC	$154.88	$253.29	$433.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.84 / $162.10 / $281.86	Professional		$141.84	$162.10	$281.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $58.82 / $104.27	Professional	26	$42.78	$58.82	$104.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.63 / $119.33 / $149.16	Professional	TC	$77.63	$119.33	$149.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.68 / $165.88 / $256.01	Professional		$46.68	$165.88	$256.01
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $192.15 / $253.29 / $405.26	Professional		$192.15	$253.29	$405.26
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $52.93 / $56.49 / $177.53	Professional	26	$52.93	$56.49	$177.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.16 / $392.20 / $809.84	Professional		$182.16	$392.20	$809.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.00 / $67.90 / $132.35	Professional	26	$44.00	$67.90	$132.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.94 / $298.32 / $690.58	Professional	TC	$134.94	$298.32	$690.58
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $409.92 / $516.48 / $530.79	Facility	26	$409.92	$516.48	$530.79
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $2,885.07 / $2,968.23 / $2,983.73	Professional		$2,885.07	$2,968.23	$2,983.73
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $505.24 / $505.24 / $505.24	Professional	26	$505.24	$505.24	$505.24
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,573.94 / $2,638.88 / $2,710.11	Professional	TC	$2,573.94	$2,638.88	$2,710.11
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $95.13 / $275.85 / $626.08	Professional		$95.13	$275.85	$626.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.64 / $89.66 / $217.36	Professional	26	$70.64	$89.66	$217.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.21 / $260.45 / $631.40	Professional	TC	$205.21	$260.45	$631.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $205.65 / $390.98	Professional		$60.59	$205.65	$390.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $197.84 / $420.90 / $772.33	Professional		$197.84	$420.90	$772.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.25 / $67.90 / $132.35	Professional	26	$47.25	$67.90	$132.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $138.02 / $285.69 / $663.27	Professional	TC	$138.02	$285.69	$663.27
United Facility/Professional Professional Modifier Low / Median / High Price $214.72 / $373.53 / $672.58	Professional		$214.72	$373.53	$672.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.96 / $61.35 / $114.63	Professional	26	$48.96	$61.35	$114.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.69 / $300.27 / $544.72	Professional	TC	$165.69	$300.27	$544.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.10 / $202.63 / $288.23	Professional		$181.10	$202.63	$288.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.38 / $53.47 / $73.80	Professional	26	$46.38	$53.47	$73.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $134.72 / $157.44 / $1,400.00	Professional	TC	$134.72	$157.44	$1,400.00