Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.95 / $6.45 / $10.80	Facility	26	$4.95	$6.45	$10.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $21.53 / $40.61	Professional		$16.64	$21.53	$40.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.33 / $7.02 / $13.46	Professional	26	$5.33	$7.02	$13.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.90 / $14.78 / $28.61	Professional	TC	$10.90	$14.78	$28.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.81 / $29.26 / $40.89	Professional		$15.81	$29.26	$40.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.85 / $9.00 / $14.99	Professional	26	$5.85	$9.00	$14.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.32 / $18.04 / $26.28	Professional		$6.32	$18.04	$26.28
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $23.57 / $31.00 / $36.59	Professional		$23.57	$31.00	$36.59
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.24 / $7.88	Professional	26	$7.24	$7.24	$7.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $25.84 / $45.61	Professional		$18.17	$25.84	$45.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.15 / $8.64 / $15.48	Professional	26	$6.15	$8.64	$15.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.28 / $17.64 / $31.14	Professional	TC	$12.28	$17.64	$31.14
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 $204.98 / $542.00 / $542.00	Professional		$204.98	$542.00	$542.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.74 / $62.74 / $62.74	Professional	26	$62.74	$62.74	$62.74
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $142.65 / $498.00 / $498.00	Professional	TC	$142.65	$498.00	$498.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $13.63 / $38.08 / $64.68	Professional		$13.63	$38.08	$64.68
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $12.28 / $29.76	Professional	26	$9.67	$12.28	$29.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $26.68 / $64.68	Professional	TC	$21.02	$26.68	$64.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.41 / $19.04 / $38.93	Professional		$8.41	$19.04	$38.93
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.98 / $63.25	Professional		$19.05	$28.98	$63.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $8.42 / $15.01	Professional	26	$6.16	$8.42	$15.01
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $12.38 / $17.17 / $30.57	Professional	TC	$12.38	$17.17	$30.57
United Facility/Professional Professional Modifier Low / Median / High Price $19.63 / $23.87 / $38.94	Professional		$19.63	$23.87	$38.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.59 / $7.89 / $13.04	Professional	26	$6.59	$7.89	$13.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.89 / $16.14 / $25.51	Professional	TC	$12.89	$16.14	$25.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $22.59 / $32.01	Professional		$20.14	$22.59	$32.01
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $7.31 / $10.08	Professional	26	$6.35	$7.31	$10.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $15.28 / $21.92	Professional	TC	$13.80	$15.28	$21.92