Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.00 / $18.20	Facility	26	$7.94	$10.00	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $43.65 / $125.89	Professional		$30.90	$43.65	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.14 / $39.81	Professional	26	$9.55	$15.14	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.18 / $61.66	Professional	TC	$19.95	$28.18	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $60.26	Professional		$29.51	$33.88	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.59 / $16.98	Professional	26	$9.33	$12.59	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $28.84 / $40.74	Professional	TC	$25.12	$28.84	$40.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $33.88 / $44.67	Professional		$9.55	$33.88	$44.67
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $75.86	Professional		$38.02	$57.54	$75.86
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.30 / $13.18	Professional	26	$11.75	$12.30	$13.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $14.13 / $20.42	Facility	26	$3.02	$14.13	$20.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $87.10	Professional		$30.90	$44.67	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.79 / $28.84	Professional	26	$10.47	$14.79	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $60.26	Professional	TC	$20.42	$30.20	$60.26
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $85.11	Facility	26	$79.43	$79.43	$85.11
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $363.08 / $363.08	Professional		$275.42	$363.08	$363.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $100.00 / $100.00	Professional	26	$79.43	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $263.03 / $263.03	Professional	TC	$194.98	$263.03	$263.03
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.33 / $18.20	Facility	26	$7.94	$9.33	$18.20
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $109.65	Professional		$32.36	$48.98	$109.65
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $15.85 / $33.88	Professional	26	$9.77	$15.85	$33.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $32.36 / $66.07	Professional	TC	$21.88	$32.36	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $32.36 / $33.11	Professional		$24.55	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $40.74 / $81.28	Professional		$13.49	$40.74	$81.28
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $14.13 / $20.42	Facility	26	$3.02	$14.13	$20.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $93.33	Professional		$30.90	$44.67	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.80 / $23.99	Professional	26	$10.47	$13.80	$23.99
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.18 / $51.29	Professional	TC	$20.42	$28.18	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $40.74 / $66.07	Professional		$33.88	$40.74	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.49 / $22.39	Professional	26	$10.96	$13.49	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.92 / $44.67	Professional	TC	$22.39	$26.92	$44.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $44.67 / $52.48	Professional		$41.69	$44.67	$52.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.88 / $15.49	Professional	26	$12.30	$12.88	$15.49
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $31.62 / $37.15	Professional	TC	$31.62	$31.62	$37.15