Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $12.65 / $19.95	Facility	26	$9.77	$12.65	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.14 / $46.56 / $91.27	Professional		$34.14	$46.56	$91.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $14.66 / $33.42	Professional	26	$10.67	$14.66	$33.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.79 / $30.06 / $56.27	Professional	TC	$22.79	$30.06	$56.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $37.13 / $46.41	Professional		$37.13	$37.13	$46.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $14.62 / $28.52	Professional	26	$11.39	$14.62	$28.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $25.43 / $31.79	Professional	TC	$25.43	$25.43	$31.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.81 / $35.01 / $56.42	Professional		$12.81	$35.01	$56.42
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $51.05 / $69.62 / $90.50	Professional		$51.05	$69.62	$90.50
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.48 / $15.37 / $29.31	Professional	26	$14.48	$15.37	$29.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.35 / $51.63 / $93.10	Professional		$37.35	$51.63	$93.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $17.46 / $31.80	Professional	26	$12.43	$17.46	$31.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $35.36 / $64.06	Professional	TC	$24.84	$35.36	$64.06
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $46.63 / $100.00 / $100.00	Facility	26	$46.63	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $321.19 / $321.19 / $420.00	Professional		$321.19	$321.19	$420.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.79 / $128.79 / $128.79	Professional	26	$128.79	$128.79	$128.79
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.00 / $254.00 / $295.35	Professional	TC	$254.00	$254.00	$295.35
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $26.79 / $63.08 / $114.40	Professional		$26.79	$63.08	$114.40
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.34 / $24.55 / $59.52	Professional	26	$19.34	$24.55	$59.52
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.73 / $55.51 / $113.45	Professional	TC	$43.73	$55.51	$113.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $51.73 / $97.04	Professional		$18.00	$51.73	$97.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.83 / $58.33 / $127.84	Professional		$38.83	$58.33	$127.84
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.66 / $16.87 / $30.52	Professional	26	$12.66	$16.87	$30.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $35.15 / $62.54	Professional	TC	$24.84	$35.15	$62.54
United Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $47.38 / $78.87	Professional		$39.26	$47.38	$78.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.02 / $15.65 / $26.41	Professional	26	$13.02	$15.65	$26.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.27 / $32.20 / $52.54	Professional	TC	$26.27	$32.20	$52.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $46.41 / $65.84	Professional		$41.41	$46.41	$65.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.70 / $14.62 / $20.17	Professional	26	$12.70	$14.62	$20.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.71 / $31.79 / $45.67	Professional	TC	$28.71	$31.79	$45.67