Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.90 / $11.52 / $18.27	Facility	26	$8.90	$11.52	$18.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.82 / $40.81 / $77.45	Professional		$28.82	$40.81	$77.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $12.19 / $23.10	Professional	26	$9.50	$12.19	$23.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $26.01 / $51.62	Professional	TC	$19.71	$26.01	$51.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $34.29 / $83.13	Professional		$28.39	$34.29	$83.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $13.05 / $25.44	Professional	26	$10.90	$13.05	$25.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.51 / $27.51 / $27.51	Professional	TC	$27.51	$27.51	$27.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.24 / $31.24 / $50.16	Professional		$11.24	$31.24	$50.16
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $60.83 / $76.72	Professional		$42.35	$60.83	$76.72
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $13.60 / $16.22	Professional	26	$12.91	$13.60	$16.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.80 / $15.80 / $15.80	Facility	26	$15.80	$15.80	$15.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $46.22 / $82.32	Professional		$31.74	$46.22	$82.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $15.03 / $28.47	Professional	26	$10.95	$15.03	$28.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $30.80 / $56.06	Professional	TC	$21.46	$30.80	$56.06
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.72 / $100.00 / $100.00	Facility	26	$41.72	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $282.23 / $282.23 / $365.85	Professional		$282.23	$282.23	$365.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.72 / $100.72 / $110.03	Professional	26	$100.72	$100.72	$110.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.00 / $254.00 / $255.75	Professional	TC	$254.00	$254.00	$255.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.79 / $63.96 / $99.75	Professional		$40.79	$63.96	$99.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $21.88 / $53.04	Professional	26	$17.23	$21.88	$53.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.84 / $48.03 / $116.44	Professional	TC	$37.84	$48.03	$116.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.90 / $36.27 / $73.40	Professional		$14.90	$36.27	$73.40
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $15.80 / $15.80 / $15.80	Facility	26	$15.80	$15.80	$15.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.38 / $51.44 / $111.43	Professional		$33.38	$51.44	$111.43
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $14.71 / $27.88	Professional	26	$11.06	$14.71	$27.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $30.61 / $53.72	Professional	TC	$21.45	$30.61	$53.72
United Facility/Professional Professional Modifier Low / Median / High Price $34.94 / $42.45 / $69.87	Professional		$34.94	$42.45	$69.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $14.41 / $24.19	Professional	26	$11.88	$14.41	$24.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.45 / $27.78 / $44.78	Professional	TC	$22.45	$27.78	$44.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $40.54 / $57.54	Professional		$36.15	$40.54	$57.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $13.05 / $18.02	Professional	26	$11.32	$13.05	$18.02
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $27.51 / $39.51	Professional	TC	$24.84	$27.51	$39.51