Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.95 / $6.45 / $10.23	Facility	26	$4.95	$6.45	$10.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.72 / $28.12 / $67.95	Professional		$18.72	$28.12	$67.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.41 / $7.45 / $19.34	Professional	26	$5.41	$7.45	$19.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $46.46 / $97.50 / $97.50	Professional	50	$46.46	$97.50	$97.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.73 / $12.15 / $19.43	Professional	52	$9.73	$12.15	$19.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.04 / $18.53 / $37.50	Professional	TC	$14.04	$18.53	$37.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.38 / $22.32 / $46.93	Professional		$18.38	$22.32	$46.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $7.31 / $14.99	Professional	26	$5.70	$7.31	$14.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.16 / $18.95 / $24.91	Professional	TC	$15.16	$18.95	$24.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.27 / $20.07 / $31.60	Professional		$6.27	$20.07	$31.60
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $32.93 / $49.72	Professional		$24.00	$32.93	$49.72
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.79 / $17.29	Professional	26	$7.24	$7.79	$17.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $29.66 / $53.60	Professional		$21.70	$29.66	$53.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.36 / $8.86 / $16.16	Professional	26	$6.36	$8.86	$16.16
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $42.42	Professional	50	$35.13	$35.13	$42.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.12 / $21.49 / $39.22	Professional	TC	$15.12	$21.49	$39.22
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 Professional Modifier Low / Median / High Price $184.96 / $184.96 / $238.88	Professional		$184.96	$184.96	$238.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.33 / $67.13 / $67.13	Professional	26	$62.33	$67.13	$67.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $149.00 / $149.00 / $176.55	Professional	TC	$149.00	$149.00	$176.55
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $41.24 / $65.47	Professional		$18.00	$41.24	$65.47
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $12.28 / $29.76	Professional	26	$9.67	$12.28	$29.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.07 / $33.08 / $80.20	Professional	TC	$26.07	$33.08	$80.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.38 / $30.72 / $46.93	Professional		$9.38	$30.72	$46.93
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.32 / $33.83 / $74.26	Professional		$22.32	$33.83	$74.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $8.48 / $15.24	Professional	26	$6.42	$8.48	$15.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $15.12 / $21.17 / $38.47	Professional	TC	$15.12	$21.17	$38.47
United Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $27.48 / $45.82	Professional		$23.10	$27.48	$45.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $7.89 / $13.28	Professional	26	$6.64	$7.89	$13.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $19.73 / $31.74	Professional	TC	$16.17	$19.73	$31.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.46 / $26.26 / $37.29	Professional		$23.46	$26.26	$37.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $7.31 / $10.08	Professional	26	$6.35	$7.31	$10.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $18.95 / $27.20	Professional	TC	$17.11	$18.95	$27.20