Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.98 / $5.01 / $9.33	Facility	26	$3.98	$5.01	$9.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.62 / $56.23 / $309.03	Facility	TC	$18.62	$56.23	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $33.11 / $109.65	Professional		$17.78	$33.11	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $8.32 / $25.12	Professional	26	$5.01	$8.32	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $54.95	Professional	TC	$16.60	$23.99	$54.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.84 / $41.69	Professional		$19.05	$28.84	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.79 / $6.17 / $11.75	Professional	26	$4.79	$6.17	$11.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $21.38 / $28.18	Professional	TC	$14.45	$21.38	$28.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $22.39 / $29.51	Professional		$4.90	$22.39	$29.51
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.88 / $51.29	Professional		$22.91	$33.88	$51.29
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $20.89 / $21.88	Facility	TC	$20.89	$20.89	$21.88
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $17.38 / $17.38	Professional	26	$6.03	$17.38	$17.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.55 / $7.24 / $10.47	Facility	26	$1.55	$7.24	$10.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.25 / $24.55 / $35.48	Facility	TC	$5.25	$24.55	$35.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $31.62 / $60.26	Professional		$22.91	$31.62	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $7.41 / $14.79	Professional	26	$5.37	$7.41	$14.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $47.86	Professional	TC	$16.98	$23.99	$47.86
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	TC	$147.91	$147.91	$147.91
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $245.47 / $245.47	Professional		$186.21	$245.47	$245.47
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	26	$54.95	$54.95	$54.95
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $194.98 / $194.98	Professional	TC	$147.91	$194.98	$194.98
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3.98 / $5.25 / $8.51	Facility	26	$3.98	$5.25	$8.51
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $17.38 / $29.51 / $323.59	Facility	TC	$17.38	$29.51	$323.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $34.67 / $87.10	Professional		$19.95	$34.67	$87.10
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $7.94 / $20.89	Professional	26	$5.01	$7.94	$20.89
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $26.30 / $51.29	Professional	TC	$16.60	$26.30	$51.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.37 / $32.36 / $33.11	Professional		$5.37	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $64.57 / $79.43	Professional		$42.66	$64.57	$79.43
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $1.55 / $7.24 / $10.47	Facility	26	$1.55	$7.24	$10.47
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $5.25 / $24.55 / $35.48	Facility	TC	$5.25	$24.55	$35.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $66.07	Professional		$22.91	$30.90	$66.07
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $6.92 / $12.02	Professional	26	$5.37	$6.92	$12.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $42.66	Professional	TC	$16.98	$21.88	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $27.54 / $45.71	Professional		$22.91	$27.54	$45.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $6.46 / $10.96	Professional	26	$5.50	$6.46	$10.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $35.48	Professional	TC	$17.38	$21.38	$35.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $28.84 / $33.88	Professional		$27.54	$28.84	$33.88
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.46 / $7.76	Professional	26	$6.17	$6.46	$7.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $22.39 / $26.30	Professional	TC	$21.38	$22.39	$26.30