Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.11 / $11.80 / $18.69	Facility	26	$9.11	$11.80	$18.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.15 / $97.27 / $394.37	Facility	TC	$33.15	$97.27	$394.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $50.89 / $93.14	Professional		$37.15	$50.89	$93.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $13.64 / $25.69	Professional	26	$9.80	$13.64	$25.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.08 / $33.29 / $68.75	Professional	TC	$26.08	$33.29	$68.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $42.52 / $69.59	Professional		$35.02	$42.52	$69.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $14.69 / $26.03	Professional	26	$10.60	$14.69	$26.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.67 / $29.34 / $31.18	Professional	TC	$25.67	$29.34	$31.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.51 / $38.10 / $58.86	Professional		$11.51	$38.10	$58.86
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $47.12 / $63.26 / $89.05	Professional		$47.12	$63.26	$89.05
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $35.45 / $36.68 / $39.06	Facility	TC	$35.45	$36.68	$39.06
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $13.22 / $14.40	Professional	26	$13.22	$13.22	$14.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $16.14	Facility	26	$16.14	$16.14	$16.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.74 / $44.74 / $44.74	Facility	TC	$44.74	$44.74	$44.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.99 / $54.46 / $98.62	Professional		$38.99	$54.46	$98.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $16.50 / $29.33	Professional	26	$11.40	$16.50	$29.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.51 / $38.61 / $70.98	Professional	TC	$27.51	$38.61	$70.98
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 Facility Modifier TC Low / Median / High Price $84.96 / $219.36 / $219.36	Facility	TC	$84.96	$219.36	$219.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $345.18 / $345.18 / $453.53	Professional		$345.18	$345.18	$453.53
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.67 / $89.67 / $112.88	Professional	26	$89.67	$89.67	$112.88
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $255.46 / $255.46 / $340.65	Professional	TC	$255.46	$255.46	$340.65
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $41.60 / $86.46 / $169.20	Professional		$41.60	$86.46	$169.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.67 / $22.42 / $54.36	Professional	26	$17.67	$22.42	$54.36
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.47 / $64.05 / $155.28	Professional	TC	$50.47	$64.05	$155.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.11 / $44.92 / $92.61	Professional		$15.11	$44.92	$92.61
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $16.14	Facility	26	$16.14	$16.14	$16.14
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $44.74 / $44.74 / $44.74	Facility	TC	$44.74	$44.74	$44.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.57 / $61.78 / $129.02	Professional		$39.57	$61.78	$129.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $15.88 / $28.47	Professional	26	$11.78	$15.88	$28.47
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $37.85 / $70.08	Professional	TC	$27.17	$37.85	$70.08
United Facility/Professional Professional Modifier Low / Median / High Price $40.68 / $50.06 / $80.83	Professional		$40.68	$50.06	$80.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $15.15 / $24.59	Professional	26	$12.32	$15.15	$24.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.07 / $35.65 / $57.21	Professional	TC	$29.07	$35.65	$57.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $44.72 / $50.03 / $71.17	Professional		$44.72	$50.03	$71.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.60 / $13.35 / $18.47	Professional	26	$11.60	$13.35	$18.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.13 / $36.68 / $52.72	Professional	TC	$33.13	$36.68	$52.72