Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $10.00 / $19.05	Facility	26	$8.51	$10.00	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $67.61 / $194.98	Professional		$40.74	$67.61	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $17.38 / $50.12	Professional	26	$10.23	$17.38	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $81.28	Professional	TC	$28.84	$40.74	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $79.43	Professional		$34.67	$44.67	$79.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.59 / $23.99	Professional	26	$9.77	$12.59	$23.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.02 / $53.70	Professional	TC	$29.51	$38.02	$53.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $42.66 / $54.95	Professional		$10.23	$42.66	$54.95
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $100.00	Professional		$47.86	$63.10	$100.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $30.90 / $30.90	Professional	26	$12.30	$30.90	$30.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.16 / $14.79 / $21.38	Facility	26	$3.16	$14.79	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $109.65	Professional		$39.81	$57.54	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.60 / $33.88	Professional	26	$10.96	$16.60	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $41.69 / $77.62	Professional	TC	$28.18	$41.69	$77.62
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $346.74 / $457.09	Professional		$66.07	$346.74	$457.09
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Professional	26	$114.82	$114.82	$114.82
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $346.74	Professional	TC	$257.04	$346.74	$346.74
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $10.47 / $16.98	Facility	26	$8.51	$10.47	$16.98
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $144.54	Professional		$40.74	$66.07	$144.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $41.69	Professional	26	$10.00	$16.98	$41.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $85.11	Professional	TC	$28.84	$44.67	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $33.11 / $42.66	Professional		$10.72	$33.11	$42.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $52.48 / $109.65	Professional		$13.80	$52.48	$109.65
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.16 / $14.79 / $21.38	Facility	26	$3.16	$14.79	$21.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $114.82	Professional		$39.81	$56.23	$114.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.49 / $28.84	Professional	26	$10.96	$15.49	$28.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.02 / $67.61	Professional	TC	$27.54	$38.02	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $81.28	Professional		$40.74	$51.29	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.79 / $24.55	Professional	26	$12.02	$14.79	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $37.15 / $58.88	Professional	TC	$28.18	$37.15	$58.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $54.95 / $66.07	Professional		$52.48	$54.95	$66.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $13.18 / $15.85	Professional	26	$12.59	$13.18	$15.85
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $41.69 / $50.12	Professional	TC	$39.81	$41.69	$50.12