Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.00 / $19.95	Facility	26	$8.91	$10.00	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $43.65 / $102.33	Professional		$30.20	$43.65	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.13 / $34.67	Professional	26	$10.00	$14.13	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $57.54	Professional	TC	$19.95	$28.84	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $64.57	Professional		$28.18	$34.67	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.18 / $25.70	Professional	26	$10.47	$13.18	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $24.55 / $29.51	Professional	TC	$19.95	$24.55	$29.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $33.11 / $46.77	Professional		$11.22	$33.11	$46.77
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $67.61	Professional		$38.02	$50.12	$67.61
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $16.22	Professional	26	$12.88	$16.22	$16.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $87.10	Professional		$33.11	$46.77	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.49 / $30.90	Professional	26	$10.96	$15.49	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $58.88	Professional	TC	$21.88	$32.36	$58.88
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 $281.84 / $363.08 / $363.08	Professional		$281.84	$363.08	$363.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $109.65 / $109.65	Professional	26	$100.00	$109.65	$109.65
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $257.04 / $257.04	Professional	TC	$251.19	$257.04	$257.04
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.47 / $19.95	Facility	26	$8.91	$10.47	$19.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $50.12 / $107.15	Professional		$32.36	$50.12	$107.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.60 / $34.67	Professional	26	$10.00	$16.60	$34.67
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $66.07	Professional	TC	$21.38	$33.11	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $32.36 / $35.48	Professional		$11.48	$32.36	$35.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $43.65 / $93.33	Professional		$13.80	$43.65	$93.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $97.72	Professional		$33.11	$46.77	$97.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.79 / $25.70	Professional	26	$10.96	$14.79	$25.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $29.51 / $52.48	Professional	TC	$21.38	$29.51	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $69.18	Professional		$34.67	$41.69	$69.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $14.45 / $23.99	Professional	26	$11.75	$14.45	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.18 / $44.67	Professional	TC	$22.39	$28.18	$44.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $42.66 / $51.29	Professional		$40.74	$42.66	$51.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.49 / $16.22	Professional	26	$13.18	$13.49	$16.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $29.51 / $34.67	Professional	TC	$28.18	$29.51	$34.67