Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.26 / $23.82 / $37.86	Facility	26	$18.26	$23.82	$37.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.16 / $89.64 / $171.81	Professional		$68.16	$89.64	$171.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $25.65 / $64.84	Professional	26	$19.60	$25.65	$64.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.87 / $61.80 / $109.83	Professional	TC	$47.87	$61.80	$109.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $91.16 / $123.92	Professional		$71.53	$91.16	$123.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $29.74 / $52.73	Professional	26	$21.63	$29.74	$52.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.44 / $43.44 / $43.44	Professional	TC	$43.44	$43.44	$43.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $70.76 / $111.62	Professional		$23.62	$70.76	$111.62
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $133.63 / $178.18	Professional		$81.00	$133.63	$178.18
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.97 / $26.77 / $28.35	Professional	26	$25.97	$26.77	$28.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.84 / $98.25 / $185.70	Professional		$71.84	$98.25	$185.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $28.87 / $54.01	Professional	26	$20.21	$28.87	$54.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.93 / $69.29 / $129.93	Professional	TC	$49.93	$69.29	$129.93
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $67.28 / $139.60 / $139.60	Facility	26	$67.28	$139.60	$139.60
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $648.50 / $648.50 / $804.75	Professional		$648.50	$648.50	$804.75
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $180.32 / $180.32 / $229.28	Professional	26	$180.32	$180.32	$229.28
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $468.12 / $468.12 / $575.40	Professional	TC	$468.12	$468.12	$575.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.01 / $121.11 / $229.20	Professional		$34.01	$121.11	$229.20
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.74 / $45.36 / $109.96	Professional	26	$35.74	$45.36	$109.96
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.36 / $108.34 / $262.64	Professional	TC	$85.36	$108.34	$262.64
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.42 / $96.26 / $175.40	Professional		$32.42	$96.26	$175.40
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $112.08 / $247.03	Professional		$73.23	$112.08	$247.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.34 / $28.67 / $51.41	Professional	26	$19.34	$28.67	$51.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $50.95 / $67.05 / $128.47	Professional	TC	$50.95	$67.05	$128.47
United Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $92.91 / $153.62	Professional		$75.95	$92.91	$153.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.27 / $29.15 / $46.71	Professional	26	$21.27	$29.15	$46.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.76 / $104.83	Professional	TC	$53.70	$63.76	$104.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.51 / $89.09 / $126.52	Professional		$79.51	$89.09	$126.52
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $27.04 / $37.31	Professional	26	$23.46	$27.04	$37.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.04 / $62.05 / $89.21	Professional	TC	$56.04	$62.05	$89.21