Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $10.00 / $16.60	Facility	26	$8.32	$10.00	$16.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $42.66 / $123.03	Professional		$23.44	$42.66	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.85 / $43.65	Professional	26	$10.00	$15.85	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $29.51 / $60.26	Professional	TC	$19.95	$29.51	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $36.31 / $57.54	Professional		$26.30	$36.31	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.02 / $23.44	Professional	26	$9.55	$12.02	$23.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $27.54 / $38.02	Professional	TC	$20.89	$27.54	$38.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $30.90 / $43.65	Professional		$10.00	$30.90	$43.65
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $74.13	Professional		$39.81	$56.23	$74.13
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $25.12 / $25.12	Professional	26	$12.02	$25.12	$25.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $85.11	Professional		$31.62	$44.67	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.14 / $29.51	Professional	26	$10.72	$15.14	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $57.54	Professional	TC	$20.89	$30.20	$57.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $354.81 / $354.81	Professional		$269.15	$354.81	$354.81
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $102.33 / $102.33	Professional	26	$93.33	$102.33	$102.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $251.19 / $251.19	Professional	TC	$229.09	$251.19	$251.19
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $10.47 / $16.60	Facility	26	$8.32	$10.47	$16.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $47.86 / $102.33	Professional		$28.18	$47.86	$102.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.85 / $36.31	Professional	26	$10.00	$15.85	$36.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.11 / $64.57	Professional	TC	$20.89	$33.11	$64.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.36 / $33.88	Professional		$10.72	$32.36	$33.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $43.65 / $89.13	Professional		$13.49	$43.65	$89.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $95.50	Professional		$31.62	$44.67	$95.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.13 / $25.12	Professional	26	$10.72	$14.13	$25.12
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.18 / $51.29	Professional	TC	$20.42	$28.18	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $39.81 / $66.07	Professional		$33.11	$39.81	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.88 / $22.39	Professional	26	$10.96	$12.88	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $26.92 / $43.65	Professional	TC	$21.38	$26.92	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $50.12	Professional		$39.81	$41.69	$50.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.88 / $15.49	Professional	26	$12.30	$12.88	$15.49
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $28.84 / $34.67	Professional	TC	$27.54	$28.84	$34.67