Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.83 / $7.58 / $12.00	Facility	26	$5.83	$7.58	$12.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $28.80 / $59.22	Professional		$19.39	$28.80	$59.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $8.84 / $21.43	Professional	26	$6.32	$8.84	$21.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.61 / $12.86 / $21.57	Professional	52	$9.61	$12.86	$21.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.91 / $19.48 / $38.97	Professional	TC	$12.91	$19.48	$38.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.55 / $28.55 / $28.55	Professional		$28.55	$28.55	$28.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.43 / $12.10 / $14.14	Professional	26	$9.43	$12.10	$14.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $10.27 / $10.27 / $10.27	Professional	TC	$10.27	$10.27	$10.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.84 / $20.17 / $33.28	Professional		$7.84	$20.17	$33.28
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $28.26 / $40.36 / $45.21	Professional		$28.26	$40.36	$45.21
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $8.49 / $9.48	Professional	26	$8.49	$8.49	$9.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.54 / $36.52 / $68.87	Professional		$23.54	$36.52	$68.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $11.41 / $20.84	Professional	26	$7.50	$11.41	$20.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.32 / $25.83 / $49.48	Professional	TC	$16.32	$25.83	$49.48
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 $216.00 / $216.00 / $244.05	Professional		$216.00	$216.00	$244.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.26 / $79.26 / $79.26	Professional	26	$79.26	$79.26	$79.26
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.93 / $205.00 / $205.00	Professional	TC	$170.93	$205.00	$205.00
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $35.18 / $46.43 / $85.80	Professional		$35.18	$46.43	$85.80
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.35 / $14.40 / $34.92	Professional	26	$11.35	$14.40	$34.92
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.23 / $32.03 / $77.64	Professional	TC	$25.23	$32.03	$77.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.10 / $24.91 / $49.38	Professional		$10.10	$24.91	$49.38
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.27 / $39.97 / $76.54	Professional		$24.27	$39.97	$76.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $10.79 / $20.47	Professional	26	$7.61	$10.79	$20.47
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $24.91 / $49.59	Professional	TC	$16.60	$24.91	$49.59
United Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $35.95 / $55.59	Professional		$27.63	$35.95	$55.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $10.26 / $17.26	Professional	26	$8.27	$10.26	$17.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.72 / $25.07 / $38.70	Professional	TC	$18.72	$25.07	$38.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.02 / $26.91 / $38.18	Professional		$24.02	$26.91	$38.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $8.57 / $11.85	Professional	26	$7.45	$8.57	$11.85
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.57 / $18.34 / $26.33	Professional	TC	$16.57	$18.34	$26.33