Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.61 / $7.29 / $12.23	Facility	26	$5.61	$7.29	$12.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.42 / $25.34 / $55.60	Professional		$16.42	$25.34	$55.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $8.25 / $19.41	Professional	26	$6.09	$8.25	$19.41
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.94 / $52.94 / $52.94	Professional	50	$52.94	$52.94	$52.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.96 / $15.74 / $31.86	Professional	TC	$9.96	$15.74	$31.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.57 / $17.84 / $22.77	Professional		$16.57	$17.84	$22.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $8.44 / $16.07	Professional	26	$6.60	$8.44	$16.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.25 / $11.25 / $11.25	Professional	TC	$11.25	$11.25	$11.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.09 / $18.07 / $28.12	Professional		$7.09	$18.07	$28.12
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $22.30 / $31.97 / $43.00	Professional		$22.30	$31.97	$43.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $8.88 / $13.26	Professional	26	$8.17	$8.88	$13.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.42 / $29.69 / $56.92	Professional		$19.42	$29.69	$56.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $9.97 / $18.17	Professional	26	$7.17	$9.97	$18.17
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $50.13	Professional	50	$41.47	$41.47	$50.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.45 / $20.18 / $39.10	Professional	TC	$12.45	$20.18	$39.10
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $203.00 / $203.00 / $203.00	Professional		$203.00	$203.00	$203.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.21 / $84.21 / $84.21	Professional	26	$84.21	$84.21	$84.21
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.33 / $165.00 / $165.00	Professional	TC	$131.33	$165.00	$165.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $22.30 / $38.43 / $75.40	Professional		$22.30	$38.43	$75.40
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $15.01 / $22.32	Professional	26	$10.93	$15.01	$22.32
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.34 / $24.55 / $59.52	Professional	TC	$19.34	$24.55	$59.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.11 / $19.77 / $62.00	Professional		$10.11	$19.77	$62.00
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.13 / $32.77 / $63.79	Professional		$20.13	$32.77	$63.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.29 / $9.67 / $17.54	Professional	26	$7.29	$9.67	$17.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $12.80 / $19.57 / $38.60	Professional	TC	$12.80	$19.57	$38.60
United Facility/Professional Professional Modifier Low / Median / High Price $23.97 / $28.81 / $47.86	Professional		$23.97	$28.81	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $8.91 / $15.01	Professional	26	$7.50	$8.91	$15.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.95 / $20.47 / $32.40	Professional	TC	$15.95	$20.47	$32.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.88 / $22.30 / $31.58	Professional		$19.88	$22.30	$31.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $8.25 / $11.41	Professional	26	$7.18	$8.25	$11.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.70 / $14.06 / $20.17	Professional	TC	$12.70	$14.06	$20.17