Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $12.02 / $21.88	Facility	26	$9.77	$12.02	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $75.86 / $229.09	Professional		$52.48	$75.86	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.95 / $60.26	Professional	26	$12.02	$19.95	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $52.48 / $109.65	Professional	TC	$38.90	$52.48	$109.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $102.33	Professional		$47.86	$64.57	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.22 / $28.18	Professional	26	$11.75	$16.22	$28.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $56.23 / $67.61	Professional	TC	$42.66	$56.23	$67.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $54.95 / $70.79	Professional		$11.75	$54.95	$70.79
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $89.13 / $125.89	Professional		$58.88	$89.13	$125.89
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $14.79 / $15.49	Professional	26	$14.13	$14.79	$15.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $138.04	Professional		$50.12	$70.79	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $17.78 / $34.67	Professional	26	$12.59	$17.78	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $54.95 / $109.65	Professional	TC	$37.15	$54.95	$109.65
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $588.84 / $588.84	Professional		$457.09	$588.84	$588.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $123.03 / $123.03	Professional	26	$95.50	$123.03	$123.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $467.74 / $467.74	Professional	TC	$354.81	$467.74	$467.74
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $12.30 / $19.50	Facility	26	$9.12	$12.30	$19.50
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $181.97	Professional		$52.48	$83.18	$181.97
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.05 / $47.86	Professional	26	$12.02	$19.05	$47.86
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $58.88 / $120.23	Professional	TC	$39.81	$58.88	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $33.11 / $56.23	Professional		$12.59	$33.11	$56.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $66.07 / $131.83	Professional		$15.85	$66.07	$131.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $72.44 / $151.36	Professional		$50.12	$72.44	$151.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.60 / $29.51	Professional	26	$12.59	$16.60	$29.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $51.29 / $95.50	Professional	TC	$37.15	$51.29	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $66.07 / $107.15	Professional		$53.70	$66.07	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.22 / $26.30	Professional	26	$13.18	$16.22	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $48.98 / $79.43	Professional	TC	$40.74	$48.98	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $72.44 / $85.11	Professional		$69.18	$72.44	$85.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.49 / $18.20	Professional	26	$14.79	$15.49	$18.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $56.23 / $67.61	Professional	TC	$53.70	$56.23	$67.61