Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.93 / $8.99 / $237.97	Facility	26	$6.93	$8.99	$237.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.27 / $35.35 / $103.69	Professional		$26.27	$35.35	$103.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $9.44 / $20.47	Professional	26	$7.25	$9.44	$20.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $25.99 / $53.79	Professional	TC	$18.73	$25.99	$53.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.97 / $32.83 / $65.18	Professional		$27.97	$32.83	$65.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $11.21 / $18.73	Professional	26	$7.98	$11.21	$18.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $23.83 / $33.85	Professional	TC	$18.39	$23.83	$33.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.73 / $27.54 / $43.49	Professional		$8.73	$27.54	$43.49
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $51.35 / $72.94	Professional		$38.29	$51.35	$72.94
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $10.60 / $23.03	Professional	26	$10.08	$10.60	$23.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $39.07 / $72.27	Professional		$28.16	$39.07	$72.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $11.35 / $21.16	Professional	26	$7.85	$11.35	$21.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.29 / $28.56 / $52.11	Professional	TC	$20.29	$28.56	$52.11
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $100.00 / $100.00	Facility	26	$34.36	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $252.05 / $252.05 / $330.53	Professional		$252.05	$252.05	$330.53
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 $183.85 / $183.85 / $244.43	Professional	TC	$183.85	$183.85	$244.43
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.07 / $57.26 / $89.08	Professional		$19.07	$57.26	$89.08
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.20 / $17.07 / $41.40	Professional	26	$13.20	$17.07	$41.40
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.17 / $41.73 / $111.28	Professional	TC	$36.17	$41.73	$111.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.60 / $34.71 / $66.59	Professional		$11.60	$34.71	$66.59
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.62 / $44.42 / $96.28	Professional		$28.62	$44.42	$96.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.84 / $11.22 / $19.80	Professional	26	$7.84	$11.22	$19.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.29 / $28.16 / $50.42	Professional	TC	$20.29	$28.16	$50.42
United Facility/Professional Professional Modifier Low / Median / High Price $29.65 / $36.69 / $61.79	Professional		$29.65	$36.69	$61.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.40 / $11.31 / $18.71	Professional	26	$8.40	$11.31	$18.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.37 / $26.15 / $43.07	Professional	TC	$21.37	$26.15	$43.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $32.58 / $36.47 / $51.81	Professional		$32.58	$36.47	$51.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.19 / $14.05	Professional	26	$8.83	$10.19	$14.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.74 / $26.28 / $37.76	Professional	TC	$23.74	$26.28	$37.76