Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.91 / $14.79	Facility	26	$7.08	$8.91	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $63.10 / $416.87	Facility	TC	$19.05	$63.10	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $123.03	Professional		$26.92	$38.90	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $43.65	Professional	26	$8.91	$14.13	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.12 / $56.23	Professional	TC	$18.20	$25.12	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $29.51 / $50.12	Professional		$22.39	$29.51	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $20.42	Professional	26	$8.32	$10.72	$20.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.44 / $37.15	Professional	TC	$18.20	$23.44	$37.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $28.84 / $38.90	Professional		$8.51	$28.84	$38.90
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $64.57	Professional		$34.67	$46.77	$64.57
Christus Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $23.99 / $25.12	Facility	TC	$23.44	$23.99	$25.12
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $22.39 / $22.39	Professional	26	$10.47	$22.39	$22.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $18.20	Facility	26	$2.69	$12.59	$18.20
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	TC	$6.03	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $70.79	Professional		$26.92	$38.02	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.88 / $24.55	Professional	26	$9.12	$12.88	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.30 / $51.29	Professional	TC	$17.78	$26.30	$51.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	TC	$165.96	$165.96	$165.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $309.03	Professional		$234.42	$309.03	$309.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $89.13 / $89.13	Professional	26	$70.79	$89.13	$89.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $223.87 / $223.87	Professional	TC	$165.96	$223.87	$223.87
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.91 / $14.45	Facility	26	$7.08	$8.91	$14.45
Moda Health Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $35.48 / $416.87	Facility	TC	$19.05	$35.48	$416.87
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $89.13	Professional		$26.92	$41.69	$89.13
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.80 / $36.31	Professional	26	$8.51	$13.80	$36.31
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.54 / $56.23	Professional	TC	$18.20	$27.54	$56.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $32.36 / $33.11	Professional		$8.91	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $33.88 / $69.18	Professional		$10.96	$33.88	$69.18
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $18.20	Facility	26	$2.69	$12.59	$18.20
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	TC	$6.03	$28.18	$40.74
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.02 / $81.28	Professional		$27.54	$38.02	$81.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $20.89	Professional	26	$9.12	$12.02	$20.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.99 / $44.67	Professional	TC	$17.78	$23.99	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $34.67 / $57.54	Professional		$28.84	$34.67	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $11.48 / $19.05	Professional	26	$9.55	$11.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $22.91 / $38.90	Professional	TC	$19.50	$22.91	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $36.31 / $42.66	Professional		$34.67	$36.31	$42.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.96 / $13.18	Professional	26	$10.47	$10.96	$13.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $25.12 / $30.20	Professional	TC	$23.99	$25.12	$30.20