Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.10 / $14.34 / $22.69	Facility	26	$11.10	$14.34	$22.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.83 / $68.64 / $119.62	Professional		$52.83	$68.64	$119.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $15.61 / $26.57	Professional	26	$11.77	$15.61	$26.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.40 / $51.73 / $92.48	Professional	TC	$40.40	$51.73	$92.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $62.71 / $151.63	Professional		$36.99	$62.71	$151.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.97 / $27.72 / $31.61	Professional	26	$12.97	$27.72	$31.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $55.32 / $85.73	Professional		$14.00	$55.32	$85.73
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $110.96 / $134.13	Professional		$61.00	$110.96	$134.13
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $16.05 / $16.05 / $17.43	Professional	26	$16.05	$16.05	$17.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.67 / $78.90 / $147.19	Professional		$55.67	$78.90	$147.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.78 / $19.32 / $35.15	Professional	26	$13.78	$19.32	$35.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.23 / $58.98 / $111.91	Professional	TC	$42.23	$58.98	$111.91
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $84.60 / $84.60	Facility	26	$50.00	$84.60	$84.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $507.76 / $507.76 / $673.88	Professional		$507.76	$507.76	$673.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $109.02 / $109.02 / $136.88	Professional	26	$109.02	$109.02	$136.88
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $398.67 / $398.67 / $537.00	Professional	TC	$398.67	$398.67	$537.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $128.09 / $247.42	Professional		$97.04	$128.09	$247.42
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.45 / $27.23 / $66.00	Professional	26	$21.45	$27.23	$66.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.47 / $100.86 / $244.52	Professional	TC	$79.47	$100.86	$244.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.38 / $71.23 / $129.44	Professional		$18.38	$71.23	$129.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $90.69 / $198.61	Professional		$56.56	$90.69	$198.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.02 / $18.62 / $34.46	Professional	26	$14.02	$18.62	$34.46
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $40.54 / $58.98 / $109.41	Professional	TC	$40.54	$58.98	$109.41
United Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $75.77 / $127.62	Professional		$60.80	$75.77	$127.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $18.39 / $30.16	Professional	26	$14.98	$18.39	$30.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.12 / $57.94 / $92.16	Professional	TC	$45.12	$57.94	$92.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $73.97 / $105.42	Professional		$66.25	$73.97	$105.42
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $16.21 / $22.44	Professional	26	$14.08	$16.21	$22.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $52.17 / $57.77 / $83.00	Professional	TC	$52.17	$57.77	$83.00