Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $7.94 / $13.49	Facility	26	$6.61	$7.94	$13.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.02 / $97.72	Professional		$25.70	$38.02	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.96 / $29.51	Professional	26	$7.76	$10.96	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $48.98	Professional	TC	$16.98	$23.99	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.18 / $57.54	Professional		$23.44	$28.18	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.77 / $17.38	Professional	26	$7.41	$9.77	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $26.92 / $26.92	Professional	TC	$26.92	$26.92	$26.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $26.92 / $36.31	Professional		$7.76	$26.92	$36.31
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $63.10	Professional		$33.88	$45.71	$63.10
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $24.55 / $24.55	Professional	26	$9.33	$24.55	$24.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.45 / $11.48 / $16.22	Facility	26	$2.45	$11.48	$16.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.81 / $74.13	Professional		$27.54	$39.81	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.30 / $24.55	Professional	26	$8.51	$12.30	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $27.54 / $50.12	Professional	TC	$18.62	$27.54	$50.12
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 $223.87 / $288.40 / $288.40	Professional		$223.87	$288.40	$288.40
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $93.33 / $93.33	Professional	26	$93.33	$93.33	$93.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	TC	$208.93	$208.93	$208.93
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.17 / $7.94 / $12.88	Facility	26	$6.17	$7.94	$12.88
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $40.74 / $91.20	Professional		$26.30	$40.74	$91.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.30 / $30.20	Professional	26	$7.94	$12.30	$30.20
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $52.48	Professional	TC	$18.20	$28.84	$52.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $32.36 / $33.11	Professional		$8.51	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $33.88 / $75.86	Professional		$10.47	$33.88	$75.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.45 / $11.48 / $16.22	Facility	26	$2.45	$11.48	$16.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.90 / $77.62	Professional		$27.54	$38.90	$77.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $20.89	Professional	26	$8.51	$11.48	$20.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $24.55 / $45.71	Professional	TC	$18.20	$24.55	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $35.48 / $57.54	Professional		$28.18	$35.48	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.96 / $18.20	Professional	26	$8.91	$10.96	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.99 / $38.90	Professional	TC	$18.62	$23.99	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $35.48 / $41.69	Professional		$33.88	$35.48	$41.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.23 / $12.30	Professional	26	$9.77	$10.23	$12.30
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $25.12 / $29.51	Professional	TC	$23.99	$25.12	$29.51