Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.12 / $10.96 / $18.20	Facility	26	$9.12	$10.96	$18.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $97.72 / $389.05	Facility	TC	$33.11	$97.72	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $134.90	Professional		$39.81	$57.54	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.22 / $41.69	Professional	26	$10.96	$16.22	$41.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $75.86 / $269.15	Professional	50	$29.51	$75.86	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $38.02 / $87.10	Professional	TC	$28.18	$38.02	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $89.13	Professional		$36.31	$52.48	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $25.12	Professional	26	$10.72	$13.49	$25.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $42.66	Professional	TC	$26.92	$36.31	$42.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $42.66 / $54.95	Professional		$10.96	$42.66	$54.95
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $60.26 / $95.50	Professional		$47.86	$60.26	$95.50
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $36.31 / $36.31 / $38.90	Facility	TC	$36.31	$36.31	$38.90
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.80 / $14.45	Professional	26	$13.18	$13.80	$14.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.47 / $15.85 / $22.91	Facility	26	$3.47	$15.85	$22.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $9.33 / $43.65 / $61.66	Facility	TC	$9.33	$43.65	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $54.95 / $107.15	Professional		$38.90	$54.95	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.60 / $32.36	Professional	26	$11.75	$16.60	$32.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $39.81 / $79.43	Professional	TC	$27.54	$39.81	$79.43
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Facility	26	$89.13	$89.13	$89.13
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $257.04 / $257.04 / $257.04	Facility	TC	$257.04	$257.04	$257.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $457.09 / $457.09	Professional		$346.74	$457.09	$457.09
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $112.20 / $112.20	Professional	26	$89.13	$112.20	$112.20
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $338.84	Professional	TC	$257.04	$338.84	$338.84
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $11.75 / $18.20	Facility	26	$8.91	$11.75	$18.20
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $61.66 / $407.38	Facility	TC	$32.36	$61.66	$407.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $61.66 / $128.82	Professional		$39.81	$61.66	$128.82
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.38 / $40.74	Professional	26	$10.96	$17.38	$40.74
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $75.86 / $269.15	Professional	50	$29.51	$75.86	$269.15
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $42.66 / $89.13	Professional	TC	$28.84	$42.66	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $33.11 / $43.65	Professional		$11.75	$33.11	$43.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $50.12 / $100.00	Professional		$14.79	$50.12	$100.00
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.47 / $15.85 / $22.91	Facility	26	$3.47	$15.85	$22.91
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $9.33 / $43.65 / $61.66	Facility	TC	$9.33	$43.65	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $56.23 / $114.82	Professional		$38.90	$56.23	$114.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $15.49 / $27.54	Professional	26	$11.75	$15.49	$27.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $37.15 / $69.18	Professional	TC	$26.92	$37.15	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $83.18	Professional		$41.69	$51.29	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.79 / $24.55	Professional	26	$12.30	$14.79	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $35.48 / $57.54	Professional	TC	$29.51	$35.48	$57.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $54.95 / $64.57	Professional		$52.48	$54.95	$64.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.45 / $16.98	Professional	26	$13.80	$14.45	$16.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $39.81 / $47.86	Professional	TC	$38.02	$39.81	$47.86