Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $10.96 / $19.95	Facility	26	$9.77	$10.96	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $53.70 / $151.36	Professional		$38.02	$53.70	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $16.98 / $47.86	Professional	26	$11.48	$16.98	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $70.79	Professional	TC	$25.70	$37.15	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $70.79	Professional		$33.11	$47.86	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.79 / $28.84	Professional	26	$11.48	$14.79	$28.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $36.31 / $53.70	Professional	TC	$22.91	$36.31	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $39.81 / $56.23	Professional		$12.88	$39.81	$56.23
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $97.72	Professional		$48.98	$66.07	$97.72
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $31.62 / $31.62	Professional	26	$14.45	$31.62	$31.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.80 / $17.38 / $25.12	Facility	26	$3.80	$17.38	$25.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $107.15	Professional		$40.74	$57.54	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.78 / $36.31	Professional	26	$12.88	$17.78	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $40.74 / $75.86	Professional	TC	$27.54	$40.74	$75.86
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 $338.84 / $436.52 / $436.52	Professional		$338.84	$436.52	$436.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $125.89 / $125.89	Professional	26	$117.49	$125.89	$125.89
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $316.23 / $316.23	Professional	TC	$288.40	$316.23	$316.23
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $11.48 / $19.95	Facility	26	$8.91	$11.48	$19.95
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $60.26 / $138.04	Professional		$38.90	$60.26	$138.04
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.20 / $40.74	Professional	26	$12.02	$18.20	$40.74
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $81.28	Professional	TC	$26.92	$41.69	$81.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $32.36 / $42.66	Professional		$12.88	$32.36	$42.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $53.70 / $114.82	Professional		$15.85	$53.70	$114.82
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.80 / $17.38 / $25.12	Facility	26	$3.80	$17.38	$25.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $117.49	Professional		$40.74	$56.23	$117.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.60 / $29.51	Professional	26	$12.88	$16.60	$29.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $37.15 / $67.61	Professional	TC	$27.54	$37.15	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $51.29 / $83.18	Professional		$42.66	$51.29	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $15.85 / $26.30	Professional	26	$13.18	$15.85	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $36.31 / $57.54	Professional	TC	$28.18	$36.31	$57.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $61.66	Professional		$48.98	$51.29	$61.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.49 / $18.20	Professional	26	$14.79	$15.49	$18.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $36.31 / $43.65	Professional	TC	$34.67	$36.31	$43.65