Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $6.46 / $13.18	Facility	26	$6.03	$6.46	$13.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $74.13	Professional		$20.89	$32.36	$74.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.77 / $23.99	Professional	26	$6.92	$9.77	$23.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $36.31 / $158.49	Professional	52	$30.20	$36.31	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $20.42 / $41.69	Professional	TC	$14.13	$20.42	$41.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $24.55 / $44.67	Professional		$19.05	$24.55	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.24 / $14.79	Professional	26	$7.24	$7.24	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	TC	$30.90	$30.90	$30.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $22.39 / $33.11	Professional		$7.76	$22.39	$33.11
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $37.15 / $46.77	Professional		$26.92	$37.15	$46.77
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.12 / $9.55	Professional	26	$8.51	$9.12	$9.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $75.86	Professional		$24.55	$37.15	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.48 / $22.91	Professional	26	$7.59	$11.48	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $53.70	Professional	TC	$16.98	$25.70	$53.70
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 $213.80 / $245.47 / $245.47	Professional		$213.80	$245.47	$245.47
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	26	$79.43	$79.43	$79.43
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $204.17	Professional	TC	$169.82	$169.82	$204.17
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $6.31 / $13.18	Facility	26	$5.01	$6.31	$13.18
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.02 / $83.18	Professional		$20.89	$38.02	$83.18
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $25.70	Professional	26	$7.08	$10.96	$25.70
Moda Health Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $32.36 / $33.88	Professional	52	$30.20	$32.36	$33.88
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $25.12 / $53.70	Professional	TC	$14.13	$25.12	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $32.36 / $33.11	Professional		$7.59	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $29.51 / $75.86	Professional		$9.77	$29.51	$75.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $36.31 / $75.86	Professional		$24.55	$36.31	$75.86
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.47 / $19.50	Professional	26	$7.59	$10.47	$19.50
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $50.12	Professional	TC	$16.60	$23.99	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $36.31 / $56.23	Professional		$27.54	$36.31	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.23 / $16.98	Professional	26	$8.32	$10.23	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.12 / $40.74	Professional	TC	$19.05	$25.12	$40.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $30.20 / $36.31	Professional		$28.84	$30.20	$36.31
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.55 / $11.48	Professional	26	$9.12	$9.55	$11.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $20.89 / $25.12	Professional	TC	$19.95	$20.89	$25.12