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 / $18.62	Facility	26	$7.94	$10.00	$18.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $61.66 / $162.18	Professional		$39.81	$61.66	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $51.29	Professional	26	$10.00	$16.98	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $83.18	Professional	TC	$28.18	$40.74	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $44.67 / $75.86	Professional		$33.88	$44.67	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.30 / $21.38	Professional	26	$9.55	$12.30	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $36.31 / $50.12	Professional	TC	$28.18	$36.31	$50.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $39.81 / $52.48	Professional		$10.00	$39.81	$52.48
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $95.50	Professional		$47.86	$66.07	$95.50
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $29.51 / $29.51	Professional	26	$12.02	$29.51	$29.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $107.15	Professional		$39.81	$57.54	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.60 / $33.11	Professional	26	$10.72	$16.60	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $41.69 / $79.43	Professional	TC	$28.84	$41.69	$79.43
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $331.13 / $436.52	Professional		$63.10	$331.13	$436.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $190.55 / $190.55	Professional	26	$120.23	$190.55	$190.55
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $331.13 / $331.13	Professional	TC	$295.12	$331.13	$331.13
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.23 / $16.60	Facility	26	$7.94	$10.23	$16.60
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $63.10 / $131.83	Professional		$38.90	$63.10	$131.83
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $41.69	Professional	26	$10.00	$16.22	$41.69
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $85.11	Professional	TC	$28.84	$44.67	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $33.11 / $41.69	Professional		$10.47	$33.11	$41.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $51.29 / $107.15	Professional		$13.49	$51.29	$107.15
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $114.82	Professional		$39.81	$56.23	$114.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.14 / $28.84	Professional	26	$10.72	$15.14	$28.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $67.61	Professional	TC	$28.18	$38.02	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $48.98 / $81.28	Professional		$41.69	$48.98	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.45 / $24.55	Professional	26	$12.02	$14.45	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $35.48 / $57.54	Professional	TC	$29.51	$35.48	$57.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $53.70 / $63.10	Professional		$51.29	$53.70	$63.10
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 $38.90 / $40.74 / $47.86	Professional	TC	$38.90	$40.74	$47.86