Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $10.96 / $17.36	Facility	26	$8.46	$10.96	$17.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.90 / $55.42 / $135.09	Professional		$36.90	$55.42	$135.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $13.60 / $34.38	Professional	26	$9.09	$13.60	$34.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.31 / $37.34 / $71.65	Professional	TC	$26.31	$37.34	$71.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.99 / $42.49 / $71.44	Professional		$34.99	$42.49	$71.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $12.40 / $24.18	Professional	26	$9.71	$12.40	$24.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.08 / $37.59 / $43.99	Professional	TC	$30.08	$37.59	$43.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.71 / $38.60 / $54.85	Professional		$10.71	$38.60	$54.85
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $71.00 / $97.48	Professional		$52.49	$71.00	$97.48
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $13.29 / $31.15	Professional	26	$12.28	$13.29	$31.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.78 / $55.56 / $99.98	Professional		$38.78	$55.56	$99.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $16.51 / $30.90	Professional	26	$10.58	$16.51	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.20 / $40.44 / $72.06	Professional	TC	$28.20	$40.44	$72.06
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.72 / $110.00 / $110.00	Facility	26	$41.72	$110.00	$110.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $343.08 / $343.08 / $453.98	Professional		$343.08	$343.08	$453.98
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.92 / $113.92 / $113.92	Professional	26	$113.92	$113.92	$113.92
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.85 / $259.85 / $349.13	Professional	TC	$259.85	$259.85	$349.13
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $78.59 / $121.07	Professional		$21.00	$78.59	$121.07
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $20.82 / $50.48	Professional	26	$16.41	$20.82	$50.48
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.73 / $65.65 / $159.16	Professional	TC	$51.73	$65.65	$159.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.97 / $47.49 / $87.61	Professional		$13.97	$47.49	$87.61
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $62.95 / $135.15	Professional		$40.28	$62.95	$135.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $15.65 / $29.01	Professional	26	$10.95	$15.65	$29.01
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.20 / $39.56 / $71.27	Professional	TC	$28.20	$39.56	$71.27
United Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $51.74 / $82.00	Professional		$41.00	$51.74	$82.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.15 / $14.88 / $25.20	Professional	26	$12.15	$14.88	$25.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $36.86 / $59.49	Professional	TC	$27.55	$36.86	$59.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.72 / $49.99 / $71.17	Professional		$44.72	$49.99	$71.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $12.40 / $17.14	Professional	26	$10.77	$12.40	$17.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.96 / $37.59 / $54.03	Professional	TC	$33.96	$37.59	$54.03