Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.93 / $8.98 / $14.24	Facility	26	$6.93	$8.98	$14.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $42.05 / $87.38	Professional		$27.40	$42.05	$87.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $10.03 / $16.66	Professional	26	$7.45	$10.03	$16.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.63 / $57.59	Professional	TC	$19.95	$28.63	$57.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.14 / $32.03 / $77.23	Professional		$30.14	$32.03	$77.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $11.19 / $19.82	Professional	26	$8.14	$11.19	$19.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.54 / $58.54 / $58.54	Professional	TC	$58.54	$58.54	$58.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.78 / $29.43 / $42.22	Professional		$8.78	$29.43	$42.22
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $37.68 / $56.52 / $71.42	Professional		$37.68	$56.52	$71.42
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $10.07 / $10.90	Professional	26	$10.07	$10.07	$10.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.03 / $47.16 / $83.41	Professional		$32.03	$47.16	$83.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $12.50 / $22.68	Professional	26	$8.85	$12.50	$22.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $35.20 / $61.33	Professional	TC	$22.87	$35.20	$61.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.90 / $100.00 / $100.00	Facility	26	$31.90	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $262.94 / $264.31 / $342.08	Professional		$262.94	$264.31	$342.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.24 / $117.24 / $117.24	Professional	26	$117.24	$117.24	$117.24
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $201.73 / $207.78 / $255.75	Professional	TC	$201.73	$207.78	$255.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $37.68 / $65.11 / $93.60	Professional		$37.68	$65.11	$93.60
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.46 / $17.07 / $41.40	Professional	26	$13.46	$17.07	$41.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.84 / $48.03 / $116.44	Professional	TC	$37.84	$48.03	$116.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.51 / $35.56 / $67.44	Professional		$11.51	$35.56	$67.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.45 / $51.35 / $106.49	Professional		$32.45	$51.35	$106.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $12.14 / $21.92	Professional	26	$9.00	$12.14	$21.92
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $34.10 / $59.04	Professional	TC	$22.87	$34.10	$59.04
United Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $42.50 / $68.09	Professional		$34.04	$42.50	$68.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.24 / $10.98 / $18.41	Professional	26	$9.24	$10.98	$18.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $31.26 / $49.53	Professional	TC	$24.23	$31.26	$49.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.68 / $37.68 / $53.57	Professional		$33.68	$37.68	$53.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.17 / $14.05	Professional	26	$8.83	$10.17	$14.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $27.51 / $39.51	Professional	TC	$24.84	$27.51	$39.51