Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $10.96 / $18.82	Facility	26	$8.46	$10.96	$18.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $53.08 / $104.85	Professional		$40.11	$53.08	$104.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.03 / $12.64 / $20.39	Professional	26	$9.03	$12.64	$20.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.06 / $38.51 / $69.03	Professional	TC	$30.06	$38.51	$69.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $45.04 / $60.38	Professional		$41.68	$45.04	$60.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.89 / $21.53 / $30.48	Professional	26	$8.89	$21.53	$30.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.64 / $41.55 / $64.56	Professional		$10.64	$41.55	$64.56
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $53.10 / $53.10 / $59.00	Professional		$53.10	$53.10	$59.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $12.58 / $13.72	Professional	26	$12.58	$12.58	$13.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.08 / $59.25 / $108.82	Professional		$42.08	$59.25	$108.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $15.58 / $27.91	Professional	26	$10.80	$15.58	$27.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.12 / $43.40 / $81.79	Professional	TC	$31.12	$43.40	$81.79
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $379.94 / $379.94 / $511.80	Professional		$379.94	$379.94	$511.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.23 / $83.23 / $108.90	Professional	26	$83.23	$83.23	$108.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $296.70 / $296.70 / $402.90	Professional	TC	$296.70	$296.70	$402.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $73.59 / $97.14 / $134.00	Professional		$73.59	$97.14	$134.00
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $21.35 / $51.76	Professional	26	$16.82	$21.35	$51.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.71 / $75.78 / $183.72	Professional	TC	$59.71	$75.78	$183.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.36 / $52.24 / $104.85	Professional		$14.36	$52.24	$104.85
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.44 / $68.53 / $144.91	Professional		$42.44	$68.53	$144.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $15.12 / $26.42	Professional	26	$11.07	$15.12	$26.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.06 / $42.71 / $80.55	Professional	TC	$30.06	$42.71	$80.55
United Facility/Professional Professional Modifier Low / Median / High Price $44.94 / $54.96 / $89.00	Professional		$44.94	$54.96	$89.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $14.02 / $23.36	Professional	26	$11.59	$14.02	$23.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.94 / $40.46 / $63.88	Professional	TC	$31.94	$40.46	$63.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.24 / $56.10 / $79.91	Professional		$50.24	$56.10	$79.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.04 / $12.70 / $17.52	Professional	26	$11.04	$12.70	$17.52
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $39.20 / $43.40 / $62.38	Professional	TC	$39.20	$43.40	$62.38