Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.29 / $5.59 / $9.73	Facility	26	$4.29	$5.59	$9.73
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.80 / $129.24 / $422.94	Facility	TC	$23.80	$129.24	$422.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.44 / $37.29 / $115.80	Professional		$24.44	$37.29	$115.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.88 / $6.85 / $29.00	Professional	26	$4.88	$6.85	$29.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.81 / $81.22 / $91.69	Professional	50	$72.81	$81.22	$91.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.22 / $15.73 / $23.88	Professional	52	$12.22	$15.73	$23.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $26.27 / $57.30	Professional	TC	$20.14	$26.27	$57.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $30.10 / $63.74	Professional		$24.76	$30.10	$63.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.92 / $6.78 / $12.37	Professional	26	$4.92	$6.78	$12.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $23.23 / $29.04	Professional	TC	$23.23	$23.23	$29.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.49 / $26.61 / $37.75	Professional		$5.49	$26.61	$37.75
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $44.23 / $64.00	Professional		$28.00	$44.23	$64.00
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $27.25 / $29.04 / $31.20	Facility	TC	$27.25	$29.04	$31.20
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $6.28 / $6.74 / $21.82	Professional	26	$6.28	$6.74	$21.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $35.09 / $67.95	Professional		$25.02	$35.09	$67.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.39 / $7.51 / $13.86	Professional	26	$5.39	$7.51	$13.86
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $52.65	Professional	50	$43.71	$43.71	$52.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.37 / $27.85 / $54.53	Professional	TC	$19.37	$27.85	$54.53
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $100.00 / $100.00	Facility	26	$19.63	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $67.18 / $173.52 / $173.52	Facility	TC	$67.18	$173.52	$173.52
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $241.48 / $241.48 / $324.52	Professional		$241.48	$241.48	$324.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.19 / $51.19 / $54.60	Professional	26	$51.19	$51.19	$54.60
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.06 / $199.06 / $269.93	Professional	TC	$199.06	$199.06	$269.93
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $11.23 / $48.36 / $85.27	Professional		$11.23	$48.36	$85.27
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $10.68 / $25.88	Professional	26	$8.41	$10.68	$25.88
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $12.00 / $12.00 / $12.00	Professional	50	$12.00	$12.00	$12.00
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.95 / $50.70 / $122.92	Professional	TC	$39.95	$50.70	$122.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.18 / $34.70 / $65.43	Professional		$7.18	$34.70	$65.43
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.39 / $41.09 / $93.95	Professional		$26.39	$41.09	$93.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $7.28 / $13.24	Professional	26	$5.57	$7.28	$13.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $27.85 / $53.90	Professional	TC	$19.88	$27.85	$53.90
United Facility/Professional Professional Modifier Low / Median / High Price $26.91 / $34.29 / $55.48	Professional		$26.91	$34.29	$55.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.76 / $6.86 / $11.54	Professional	26	$5.76	$6.86	$11.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.85 / $27.43 / $43.31	Professional	TC	$20.85	$27.43	$43.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.75 / $35.38 / $50.48	Professional		$31.75	$35.38	$50.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.52 / $6.34 / $8.76	Professional	26	$5.52	$6.34	$8.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.23 / $29.04 / $41.72	Professional	TC	$26.23	$29.04	$41.72