Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.34 / $27.76 / $44.09	Facility	26	$21.34	$27.76	$44.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $75.44 / $141.40	Professional		$58.23	$75.44	$141.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $31.22 / $51.21	Professional	26	$23.24	$31.22	$51.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.26 / $44.32 / $75.33	Professional	TC	$35.26	$44.32	$75.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $77.31 / $78.91	Professional		$77.31	$77.31	$78.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.19 / $34.64 / $61.41	Professional	26	$25.19	$34.64	$61.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $26.43 / $26.43	Professional	TC	$26.43	$26.43	$26.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.01 / $62.06 / $102.31	Professional		$27.01	$62.06	$102.31
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $79.36 / $113.72 / $124.27	Professional		$79.36	$113.72	$124.27
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $31.18 / $31.18 / $33.57	Professional	26	$31.18	$31.18	$33.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.91 / $87.95 / $158.21	Professional		$62.91	$87.95	$158.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.77 / $37.97 / $67.59	Professional	26	$26.77	$37.97	$67.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $51.89 / $94.54	Professional	TC	$36.22	$51.89	$94.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $78.25 / $162.16 / $162.16	Facility	26	$78.25	$162.16	$162.16
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $546.16 / $546.16 / $678.98	Professional		$546.16	$546.16	$678.98
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $210.44 / $210.44 / $267.68	Professional	26	$210.44	$210.44	$267.68
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $335.78 / $335.78 / $411.38	Professional	TC	$335.78	$335.78	$411.38
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $99.87 / $137.22 / $302.89	Professional		$99.87	$137.22	$302.89
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.63 / $52.83 / $128.08	Professional	26	$41.63	$52.83	$128.08
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.97 / $77.39 / $187.60	Professional	TC	$60.97	$77.39	$187.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $51.95 / $136.21	Professional		$35.15	$51.95	$136.21
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.28 / $99.61 / $210.34	Professional		$64.28	$99.61	$210.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.67 / $36.52 / $66.95	Professional	26	$27.67	$36.52	$66.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $50.95 / $90.73	Professional	TC	$36.22	$50.95	$90.73
United Facility/Professional Professional Modifier Low / Median / High Price $66.98 / $83.73 / $133.97	Professional		$66.98	$83.73	$133.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.65 / $35.09 / $57.95	Professional	26	$28.65	$35.09	$57.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.24 / $48.00 / $76.80	Professional	TC	$39.24	$48.00	$76.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.36 / $75.81 / $107.14	Professional		$67.36	$75.81	$107.14
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.33 / $31.49 / $43.43	Professional	26	$27.33	$31.49	$43.43
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $40.03 / $44.32 / $63.71	Professional	TC	$40.03	$44.32	$63.71