Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $7.41 / $13.80	Facility	26	$6.92	$7.41	$13.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $131.83	Professional		$30.90	$44.67	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $33.11	Professional	26	$7.94	$12.02	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $61.66	Professional	TC	$21.88	$30.20	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $39.81 / $57.54	Professional		$26.30	$39.81	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $14.13 / $19.95	Professional	26	$8.32	$14.13	$19.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.70 / $39.81	Professional	TC	$21.88	$25.70	$39.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $31.62 / $41.69	Professional		$8.32	$31.62	$41.69
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $64.57	Professional		$35.48	$41.69	$64.57
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.47 / $10.96	Professional	26	$10.00	$10.47	$10.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $87.10	Professional		$32.36	$47.86	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.88 / $24.55	Professional	26	$8.91	$12.88	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $69.18	Professional	TC	$23.99	$35.48	$69.18
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 $263.03 / $338.84 / $338.84	Professional		$263.03	$338.84	$338.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Professional	26	$117.49	$117.49	$117.49
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $257.04 / $257.04	Professional	TC	$208.93	$257.04	$257.04
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $7.41 / $13.80	Facility	26	$6.92	$7.41	$13.80
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $107.15	Professional		$30.90	$51.29	$107.15
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $28.84	Professional	26	$7.94	$12.88	$28.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $36.31 / $72.44	Professional	TC	$21.88	$36.31	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $32.36 / $33.11	Professional		$8.91	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $39.81 / $89.13	Professional		$10.96	$39.81	$89.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $95.50	Professional		$32.36	$46.77	$95.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.75 / $21.88	Professional	26	$8.91	$11.75	$21.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.88 / $57.54	Professional	TC	$23.44	$33.88	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $67.61	Professional		$33.88	$42.66	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.96 / $18.62	Professional	26	$9.33	$10.96	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $31.62 / $50.12	Professional	TC	$24.55	$31.62	$50.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $50.12	Professional		$39.81	$41.69	$50.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.96 / $12.88	Professional	26	$10.47	$10.96	$12.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $31.62 / $37.15	Professional	TC	$29.51	$31.62	$37.15