Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.56 / $12.37 / $18.89	Facility	26	$9.56	$12.37	$18.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.41 / $72.27 / $252.69	Facility	TC	$26.41	$72.27	$252.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $40.51 / $76.45	Professional		$32.08	$40.51	$76.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $14.25 / $22.96	Professional	26	$10.43	$14.25	$22.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $26.41 / $45.64	Professional	TC	$20.59	$26.41	$45.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $35.86 / $43.38	Professional		$33.94	$35.86	$43.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $14.00 / $23.41	Professional	26	$11.70	$14.00	$23.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.25 / $32.89 / $50.87	Professional		$12.25	$32.89	$50.87
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $42.42 / $48.78 / $67.00	Professional		$42.42	$48.78	$67.00
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $27.25 / $28.42 / $30.30	Facility	TC	$27.25	$28.42	$30.30
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $13.86 / $13.86 / $15.35	Professional	26	$13.86	$13.86	$15.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $46.24 / $84.84	Professional		$33.60	$46.24	$84.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.90 / $17.35 / $31.40	Professional	26	$11.90	$17.35	$31.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.13 / $29.57 / $55.78	Professional	TC	$21.13	$29.57	$55.78
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.97 / $72.72 / $72.72	Facility	26	$34.97	$72.72	$72.72
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $60.70 / $169.86 / $169.86	Facility	TC	$60.70	$169.86	$169.86
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $297.38 / $297.38 / $382.35	Professional		$297.38	$297.38	$382.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.99 / $93.99 / $118.05	Professional	26	$93.99	$93.99	$118.05
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $203.39 / $203.39 / $264.23	Professional	TC	$203.39	$203.39	$264.23
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $49.63 / $66.47 / $105.07	Professional		$49.63	$66.47	$105.07
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.50 / $23.48 / $56.92	Professional	26	$18.50	$23.48	$56.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.10 / $49.63 / $120.32	Professional	TC	$39.10	$49.63	$120.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.14 / $36.95 / $77.50	Professional		$16.14	$36.95	$77.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $52.73 / $112.40	Professional		$34.17	$52.73	$112.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.25 / $16.70 / $31.21	Professional	26	$12.25	$16.70	$31.21
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.84 / $29.00 / $54.55	Professional	TC	$20.84	$29.00	$54.55
United Facility/Professional Professional Modifier Low / Median / High Price $36.08 / $44.23 / $71.42	Professional		$36.08	$44.23	$71.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.28 / $16.55 / $26.56	Professional	26	$13.28	$16.55	$26.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.03 / $27.43 / $43.65	Professional	TC	$22.03	$27.43	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.82 / $42.42 / $60.18	Professional		$37.82	$42.42	$60.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $14.00 / $19.35	Professional	26	$12.14	$14.00	$19.35
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.67 / $28.42 / $40.84	Professional	TC	$25.67	$28.42	$40.84