Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.04 / $7.86 / $12.47	Facility	26	$6.04	$7.86	$12.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.86 / $32.14 / $67.98	Professional		$22.86	$32.14	$67.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.02 / $20.03	Professional	26	$6.55	$9.02	$20.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.97 / $21.49 / $41.46	Professional	TC	$15.97	$21.49	$41.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.64 / $28.83 / $32.78	Professional		$21.64	$28.83	$32.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.13 / $9.80 / $17.38	Professional	26	$7.13	$9.80	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.32 / $12.32 / $12.32	Professional	TC	$12.32	$12.32	$12.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.23 / $23.63 / $39.26	Professional		$8.23	$23.63	$39.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $29.37 / $35.56 / $54.64	Professional		$29.37	$35.56	$54.64
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.82 / $9.51 / $16.07	Professional	26	$8.82	$9.51	$16.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.84 / $35.83 / $62.92	Professional		$24.84	$35.83	$62.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.02 / $19.98	Professional	26	$7.76	$11.02	$19.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.22 / $24.91 / $44.55	Professional	TC	$17.22	$24.91	$44.55
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $217.42 / $217.42 / $280.35	Professional		$217.42	$217.42	$280.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.64 / $72.64 / $75.53	Professional	26	$72.64	$72.64	$75.53
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.00 / $199.00 / $204.83	Professional	TC	$199.00	$199.00	$204.83
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $53.38 / $100.48	Professional		$40.44	$53.38	$100.48
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $14.95 / $36.24	Professional	26	$11.78	$14.95	$36.24
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.28 / $38.43 / $93.16	Professional	TC	$30.28	$38.43	$93.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.91 / $29.29 / $60.00	Professional		$10.91	$29.29	$60.00
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.54 / $86.48	Professional		$25.70	$39.54	$86.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $10.68 / $19.23	Professional	26	$7.89	$10.68	$19.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $24.52 / $43.27	Professional	TC	$17.14	$24.52	$43.27
United Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $32.28 / $53.69	Professional		$26.75	$32.28	$53.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.94 / $17.11	Professional	26	$8.38	$9.94	$17.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $22.73 / $36.52	Professional	TC	$18.07	$22.73	$36.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $30.92 / $43.89	Professional		$27.61	$30.92	$43.89
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $8.91 / $12.29	Professional	26	$7.73	$8.91	$12.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $22.01 / $31.60	Professional	TC	$19.88	$22.01	$31.60