Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.11 / $11.80 / $18.45	Facility	26	$9.11	$11.80	$18.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.33 / $62.07 / $122.99	Professional		$42.33	$62.07	$122.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.81 / $14.55 / $30.22	Professional	26	$9.81	$14.55	$30.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.38 / $44.01 / $82.60	Professional	TC	$31.38	$44.01	$82.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $58.79 / $117.63	Professional		$40.15	$58.79	$117.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $13.67 / $25.96	Professional	26	$11.16	$13.67	$25.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.60 / $34.97 / $56.33	Professional	TC	$30.60	$34.97	$56.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.81 / $44.25 / $64.66	Professional		$11.81	$44.25	$64.66
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $57.38 / $81.06 / $95.81	Professional		$57.38	$81.06	$95.81
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $14.34 / $37.46	Professional	26	$13.53	$14.34	$37.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.43 / $66.94 / $119.85	Professional		$46.43	$66.94	$119.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $18.62 / $35.47	Professional	26	$11.96	$18.62	$35.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.21 / $49.21 / $89.30	Professional	TC	$34.21	$49.21	$89.30
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $49.08 / $126.00 / $126.00	Facility	26	$49.08	$126.00	$126.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $399.42 / $399.42 / $522.38	Professional		$399.42	$399.42	$522.38
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $137.04 / $137.04 / $220.00	Professional	26	$137.04	$137.04	$220.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $356.00 / $356.00 / $405.68	Professional	TC	$356.00	$356.00	$405.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $99.26 / $140.87	Professional		$24.89	$99.26	$140.87
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.07 / $22.95 / $55.64	Professional	26	$18.07	$22.95	$55.64
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.14 / $76.33 / $185.04	Professional	TC	$60.14	$76.33	$185.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $54.85 / $101.74	Professional		$15.69	$54.85	$101.74
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.77 / $75.64 / $162.27	Professional		$48.77	$75.64	$162.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $17.84 / $34.08	Professional	26	$12.17	$17.84	$34.08
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.97 / $48.55 / $86.08	Professional	TC	$33.97	$48.55	$86.08
United Facility/Professional Professional Modifier Low / Median / High Price $50.91 / $63.95 / $99.45	Professional		$50.91	$63.95	$99.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.97 / $17.44 / $27.93	Professional	26	$13.97	$17.44	$27.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.79 / $45.35 / $73.84	Professional	TC	$35.79	$45.35	$73.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.34 / $57.38 / $81.68	Professional		$51.34	$57.38	$81.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.87 / $13.67 / $18.85	Professional	26	$11.87	$13.67	$18.85
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.47 / $43.71 / $62.83	Professional	TC	$39.47	$43.71	$62.83