Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $7.94 / $239.88	Facility	26	$6.92	$7.94	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $134.90	Professional		$28.18	$40.74	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.88 / $31.62	Professional	26	$7.76	$12.88	$31.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.18 / $60.26	Professional	TC	$19.05	$28.18	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $52.48	Professional		$23.99	$33.11	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $17.38	Professional	26	$7.94	$10.47	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.30 / $41.69	Professional	TC	$22.91	$26.30	$41.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $29.51 / $40.74	Professional		$8.32	$29.51	$40.74
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $38.90 / $64.57	Professional		$34.67	$38.90	$64.57
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $23.44 / $23.44	Professional	26	$10.00	$23.44	$23.44
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 $28.18 / $39.81 / $75.86	Professional		$28.18	$39.81	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.48 / $23.44	Professional	26	$7.76	$11.48	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $56.23	Professional	TC	$20.42	$29.51	$56.23
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 $251.19 / $331.13 / $331.13	Professional		$251.19	$331.13	$331.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	26	$97.72	$97.72	$97.72
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $245.47 / $245.47	Professional	TC	$181.97	$245.47	$245.47
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $8.51 / $15.49	Facility	26	$6.92	$8.51	$15.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $45.71 / $102.33	Professional		$28.84	$45.71	$102.33
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $28.18	Professional	26	$7.94	$12.88	$28.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $63.10	Professional	TC	$20.89	$31.62	$63.10
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 / $37.15 / $77.62	Professional		$10.96	$37.15	$77.62
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 $28.18 / $39.81 / $87.10	Professional		$28.18	$39.81	$87.10
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.96 / $19.50	Professional	26	$7.76	$10.96	$19.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.92 / $50.12	Professional	TC	$19.95	$26.92	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $36.31 / $60.26	Professional		$29.51	$36.31	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $17.78	Professional	26	$8.32	$10.72	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $25.70 / $41.69	Professional	TC	$21.38	$25.70	$41.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $38.90 / $46.77	Professional		$37.15	$38.90	$46.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.47 / $12.59	Professional	26	$10.00	$10.47	$12.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.18 / $33.88	Professional	TC	$26.92	$28.18	$33.88