Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.24 / $10.68 / $17.36	Facility	26	$8.24	$10.68	$17.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.72 / $72.45 / $210.11	Facility	TC	$24.72	$72.45	$210.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $37.21 / $67.17	Professional		$28.54	$37.21	$67.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $12.53 / $20.35	Professional	26	$9.00	$12.53	$20.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $25.05 / $42.72	Professional	TC	$19.48	$25.05	$42.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $31.19 / $41.24	Professional		$27.29	$31.19	$41.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $10.34 / $24.18	Professional	26	$8.68	$10.34	$24.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $21.27 / $21.27	Professional	TC	$21.27	$21.27	$21.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $30.05 / $48.13	Professional		$10.71	$30.05	$48.13
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $40.99 / $62.38 / $77.98	Professional		$40.99	$62.38	$77.98
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $26.22 / $26.59 / $28.36	Facility	TC	$26.22	$26.59	$28.36
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $12.28 / $13.29	Professional	26	$12.28	$12.28	$13.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.06 / $43.14 / $78.64	Professional		$31.06	$43.14	$78.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $15.31 / $27.32	Professional	26	$10.54	$15.31	$27.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.26 / $28.38 / $52.48	Professional	TC	$20.26	$28.38	$52.48
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.85 / $70.00 / $70.00	Facility	26	$30.85	$70.00	$70.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $56.78 / $158.84 / $158.84	Facility	TC	$56.78	$158.84	$158.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $271.47 / $271.47 / $352.20	Professional		$271.47	$271.47	$352.20
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.06 / $81.06 / $104.93	Professional	26	$81.06	$81.06	$104.93
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.40 / $190.40 / $247.28	Professional	TC	$190.40	$190.40	$247.28
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $50.95 / $67.25 / $163.04	Professional		$50.95	$67.25	$163.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $20.82 / $50.48	Professional	26	$16.41	$20.82	$50.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.58 / $46.43 / $112.56	Professional	TC	$36.58	$46.43	$112.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.17 / $35.06 / $70.01	Professional		$14.17	$35.06	$70.01
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $48.85 / $102.63	Professional		$31.84	$48.85	$102.63
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $14.59 / $26.42	Professional	26	$10.95	$14.59	$26.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $28.20 / $52.21	Professional	TC	$20.21	$28.20	$52.21
United Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $41.39 / $71.16	Professional		$32.95	$41.39	$71.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.58 / $14.07 / $24.22	Professional	26	$11.58	$14.07	$24.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $26.53 / $43.65	Professional	TC	$22.05	$26.53	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $38.99 / $55.34	Professional		$34.79	$38.99	$55.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $12.40 / $17.14	Professional	26	$10.77	$12.40	$17.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.02 / $26.59 / $38.21	Professional	TC	$24.02	$26.59	$38.21