Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.93 / $8.98 / $15.49	Facility	26	$6.93	$8.98	$15.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.06 / $280.45 / $668.57	Facility	TC	$31.06	$280.45	$668.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.85 / $49.16 / $159.00	Professional		$29.85	$49.16	$159.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.80 / $11.50 / $42.73	Professional	26	$7.80	$11.50	$42.73
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $72.23 / $109.98 / $253.14	Professional	50	$72.23	$109.98	$253.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.18 / $19.39 / $30.65	Professional	52	$15.18	$19.39	$30.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $31.85 / $73.37	Professional	TC	$23.23	$31.85	$73.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $37.52 / $78.59	Professional		$30.65	$37.52	$78.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $11.18 / $20.43	Professional	26	$8.38	$11.18	$20.43
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.55 / $52.55 / $55.69	Professional	50	$52.55	$52.55	$55.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.66 / $28.40 / $68.29	Professional	TC	$18.66	$28.40	$68.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.06 / $34.13 / $47.80	Professional		$9.06	$34.13	$47.80
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $37.00 / $54.00 / $83.16	Professional		$37.00	$54.00	$83.16
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $31.09 / $33.31 / $36.61	Facility	TC	$31.09	$33.31	$36.61
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $10.92 / $26.95	Professional	26	$10.38	$10.92	$26.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $12.66	Facility	26	$12.66	$12.66	$12.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.63 / $40.63 / $40.63	Facility	TC	$40.63	$40.63	$40.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $46.36 / $85.19	Professional		$33.79	$46.36	$85.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $12.58 / $23.10	Professional	26	$8.93	$12.58	$23.10
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.72 / $53.72 / $65.11	Professional	50	$53.72	$53.72	$65.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.60 / $33.34 / $63.34	Professional	TC	$24.60	$33.34	$63.34
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $100.00 / $100.00	Facility	26	$29.45	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $77.14 / $199.17 / $199.17	Facility	TC	$77.14	$199.17	$199.17
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $191.00 / $297.63 / $398.70	Professional		$191.00	$297.63	$398.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $87.52 / $89.18	Professional	26	$87.52	$87.52	$89.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.42 / $229.42 / $309.52	Professional	TC	$229.42	$229.42	$309.52
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $16.28 / $62.33 / $114.75	Professional		$16.28	$62.33	$114.75
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $17.61 / $42.68	Professional	26	$13.87	$17.61	$42.68
Moda Health Facility/Professional Professional Modifier 50 Low / Median / High Price $34.89 / $122.84 / $122.84	Professional	50	$34.89	$122.84	$122.84
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.84 / $58.18 / $141.04	Professional	TC	$45.84	$58.18	$141.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.81 / $41.95 / $79.61	Professional		$11.81	$41.95	$79.61
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $12.66	Facility	26	$12.66	$12.66	$12.66
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $40.63 / $40.63 / $40.63	Facility	TC	$40.63	$40.63	$40.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $52.02 / $115.01	Professional		$34.40	$52.02	$115.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $12.14 / $21.98	Professional	26	$9.11	$12.14	$21.98
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $33.31 / $62.93	Professional	TC	$24.75	$33.31	$62.93
United Facility/Professional Professional Modifier Low / Median / High Price $35.35 / $42.36 / $69.73	Professional		$35.35	$42.36	$69.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $11.31 / $18.48	Professional	26	$9.46	$11.31	$18.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.89 / $31.20 / $51.59	Professional	TC	$25.89	$31.20	$51.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.20 / $43.79 / $62.37	Professional		$39.20	$43.79	$62.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $10.48 / $14.50	Professional	26	$9.11	$10.48	$14.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.09 / $33.31 / $47.87	Professional	TC	$30.09	$33.31	$47.87