Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $6.03 / $11.22	Facility	26	$4.90	$6.03	$11.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $23.99 / $51.29	Professional		$16.98	$23.99	$51.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.13 / $22.39	Professional	26	$5.75	$8.13	$22.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $15.85 / $30.90	Professional	TC	$10.96	$15.85	$30.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.05 / $35.48	Professional		$15.85	$19.05	$35.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $7.94 / $14.79	Professional	26	$5.89	$7.94	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $11.75 / $11.75	Professional	TC	$11.75	$11.75	$11.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $19.05 / $25.70	Professional		$6.03	$19.05	$25.70
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $30.90 / $42.66	Professional		$22.39	$30.90	$42.66
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.59 / $7.94	Professional	26	$7.24	$7.59	$7.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.30 / $50.12	Professional		$19.05	$26.30	$50.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.71 / $17.38	Professional	26	$6.17	$8.71	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $17.78 / $33.88	Professional	TC	$12.59	$17.78	$33.88
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 $204.17 / $204.17 / $537.03	Professional		$204.17	$204.17	$537.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	26	$63.10	$63.10	$63.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $141.25 / $501.19	Professional	TC	$141.25	$141.25	$501.19
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $5.62 / $11.22	Facility	26	$4.90	$5.62	$11.22
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $27.54 / $57.54	Professional		$18.20	$27.54	$57.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $9.33 / $19.95	Professional	26	$5.89	$9.33	$19.95
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $18.62 / $37.15	Professional	TC	$12.02	$18.62	$37.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $32.36 / $33.11	Professional		$6.46	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $22.39 / $48.98	Professional		$7.94	$22.39	$48.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.30 / $54.95	Professional		$19.05	$26.30	$54.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.13 / $14.45	Professional	26	$6.17	$8.13	$14.45
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $16.60 / $30.20	Professional	TC	$12.30	$16.60	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $23.44 / $38.90	Professional		$19.95	$23.44	$38.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.76 / $13.18	Professional	26	$6.61	$7.76	$13.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $15.85 / $25.70	Professional	TC	$12.88	$15.85	$25.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $23.99 / $28.18	Professional		$22.91	$23.99	$28.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $7.76 / $9.33	Professional	26	$7.59	$7.76	$9.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $16.22 / $19.05	Professional	TC	$15.14	$16.22	$19.05