Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.80 / $10.10 / $16.03	Facility	26	$7.80	$10.10	$16.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.08 / $39.33 / $67.59	Professional		$28.08	$39.33	$67.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $10.72 / $20.27	Professional	26	$8.27	$10.72	$20.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $28.17 / $48.66	Professional	TC	$19.72	$28.17	$48.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.16 / $34.78 / $79.84	Professional		$31.16	$34.78	$79.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $11.72 / $22.32	Professional	26	$9.16	$11.72	$22.32
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $22.01 / $27.51	Professional	TC	$22.01	$22.01	$27.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.02 / $29.82 / $47.26	Professional		$10.02	$29.82	$47.26
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $38.94 / $53.29 / $73.78	Professional		$38.94	$53.29	$73.78
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $11.33 / $12.26 / $25.02	Professional	26	$11.33	$12.26	$25.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.86 / $13.86 / $13.86	Facility	26	$13.86	$13.86	$13.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.52 / $43.29 / $80.90	Professional		$31.52	$43.29	$80.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $12.80 / $23.68	Professional	26	$9.15	$12.80	$23.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.25 / $31.41 / $58.04	Professional	TC	$22.25	$31.41	$58.04
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 $271.52 / $271.52 / $352.65	Professional		$271.52	$271.52	$352.65
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.41 / $97.41 / $97.41	Professional	26	$97.41	$97.41	$97.41
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $210.00 / $255.75	Professional	TC	$210.00	$210.00	$255.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $61.14 / $95.94	Professional		$23.60	$61.14	$95.94
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.13 / $19.21 / $46.56	Professional	26	$15.13	$19.21	$46.56
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 $13.47 / $35.61 / $71.36	Professional		$13.47	$35.61	$71.36
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.86 / $13.86 / $13.86	Facility	26	$13.86	$13.86	$13.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $50.23 / $107.54	Professional		$33.11	$50.23	$107.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $12.63 / $22.89	Professional	26	$9.15	$12.63	$22.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.58 / $30.80 / $56.33	Professional	TC	$22.58	$30.80	$56.33
United Facility/Professional Professional Modifier Low / Median / High Price $32.90 / $39.08 / $64.62	Professional		$32.90	$39.08	$64.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $12.08 / $20.39	Professional	26	$9.36	$12.08	$20.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.93 / $28.81 / $45.88	Professional	TC	$23.93	$28.81	$45.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $38.95 / $55.34	Professional		$34.79	$38.95	$55.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $11.45 / $15.82	Professional	26	$9.93	$11.45	$15.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $27.51 / $39.51	Professional	TC	$24.84	$27.51	$39.51