Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.28 / $21.28 / $32.53	Facility	26	$16.28	$21.28	$32.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.29 / $109.57 / $220.59	Professional		$85.29	$109.57	$220.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.02 / $24.60 / $56.88	Professional	26	$18.02	$24.60	$56.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.20 / $86.86 / $152.36	Professional	TC	$67.20	$86.86	$152.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $90.00 / $118.12	Professional		$90.00	$90.00	$118.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.09 / $29.35 / $46.52	Professional	26	$19.09	$29.35	$46.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.87 / $89.16 / $127.98	Professional		$20.87	$89.16	$127.98
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $157.50 / $213.82	Professional		$116.00	$157.50	$213.82
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $23.62 / $23.62 / $25.64	Professional	26	$23.62	$23.62	$25.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.92 / $28.92 / $28.92	Facility	26	$28.92	$28.92	$28.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.41 / $117.28 / $232.72	Professional		$79.41	$117.28	$232.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.87 / $29.18 / $52.87	Professional	26	$20.87	$29.18	$52.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.64 / $90.40 / $182.13	Professional	TC	$57.64	$90.40	$182.13
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $76.08 / $122.88 / $122.88	Facility	26	$76.08	$122.88	$122.88
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $841.81 / $841.81 / $1,024.28	Professional		$841.81	$841.81	$1,024.28
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $202.73 / $205.77 / $205.77	Professional	26	$202.73	$205.77	$205.77
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $680.78 / $680.78 / $821.48	Professional	TC	$680.78	$680.78	$821.48
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $44.87 / $165.75 / $296.95	Professional		$44.87	$165.75	$296.95
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.54 / $40.03 / $97.04	Professional	26	$31.54	$40.03	$97.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $121.94 / $154.77 / $375.20	Professional	TC	$121.94	$154.77	$375.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.43 / $131.38 / $238.26	Professional		$30.43	$131.38	$238.26
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $28.92 / $28.92 / $28.92	Facility	26	$28.92	$28.92	$28.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.88 / $127.89 / $315.92	Professional		$80.88	$127.89	$315.92
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.18 / $28.08 / $50.79	Professional	26	$21.18	$28.08	$50.79
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $57.64 / $90.32 / $169.59	Professional	TC	$57.64	$90.32	$169.59
United Facility/Professional Professional Modifier Low / Median / High Price $86.41 / $122.91 / $206.36	Professional		$86.41	$122.91	$206.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $25.85 / $43.78	Professional	26	$21.66	$25.85	$43.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.02 / $96.89 / $163.83	Professional	TC	$61.02	$96.89	$163.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.76 / $112.50 / $160.37	Professional		$100.76	$112.50	$160.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.71 / $23.86 / $32.90	Professional	26	$20.71	$23.86	$32.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $80.06 / $88.64 / $127.47	Professional	TC	$80.06	$88.64	$127.47