Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.27 / $35.38 / $54.68	Facility	26	$27.27	$35.38	$54.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $121.63 / $242.46	Professional		$96.53	$121.63	$242.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.98 / $36.34 / $73.40	Professional	26	$27.98	$36.34	$73.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.81 / $87.90 / $148.36	Professional	TC	$66.81	$87.90	$148.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.57 / $132.93 / $259.52	Professional		$101.57	$132.93	$259.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $44.11 / $78.20	Professional	26	$32.79	$44.11	$78.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.60 / $51.60 / $51.60	Professional	TC	$51.60	$51.60	$51.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.60 / $98.97 / $162.27	Professional		$34.60	$98.97	$162.27
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $126.60 / $180.45 / $253.20	Professional		$126.60	$180.45	$253.20
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $39.69 / $39.69 / $42.88	Professional	26	$39.69	$39.69	$42.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $48.64 / $48.64	Facility	26	$48.64	$48.64	$48.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.47 / $140.27 / $265.45	Professional		$101.47	$140.27	$265.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.86 / $43.07 / $79.20	Professional	26	$29.86	$43.07	$79.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.93 / $96.00 / $183.32	Professional	TC	$69.93	$96.00	$183.32
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.12 / $207.05 / $207.05	Facility	26	$100.12	$207.05	$207.05
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $927.52 / $927.52 / $1,140.83	Professional		$927.52	$927.52	$1,140.83
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $268.38 / $268.38 / $339.15	Professional	26	$268.38	$268.38	$339.15
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $659.08 / $659.08 / $801.68	Professional	TC	$659.08	$659.08	$801.68
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $218.30 / $327.39	Professional		$74.84	$218.30	$327.39
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.99 / $67.25 / $163.04	Professional	26	$52.99	$67.25	$163.04
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $119.00 / $151.04 / $366.16	Professional	TC	$119.00	$151.04	$366.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.82 / $142.06 / $255.56	Professional		$49.82	$142.06	$255.56
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $48.64 / $48.64	Facility	26	$48.64	$48.64	$48.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.23 / $159.36 / $352.78	Professional		$104.23	$159.36	$352.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.39 / $43.07 / $76.75	Professional	26	$29.39	$43.07	$76.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $70.23 / $94.16 / $179.15	Professional	TC	$70.23	$94.16	$179.15
United Facility/Professional Professional Modifier Low / Median / High Price $105.56 / $126.68 / $211.13	Professional		$105.56	$126.68	$211.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $43.01 / $70.31	Professional	26	$31.34	$43.01	$70.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.97 / $92.47 / $149.59	Professional	TC	$76.97	$92.47	$149.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.91 / $126.60 / $179.73	Professional		$112.91	$126.60	$179.73
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $40.10 / $55.34	Professional	26	$34.79	$40.10	$55.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $78.13 / $86.50 / $124.39	Professional	TC	$78.13	$86.50	$124.39