Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.56 / $40.98 / $62.96	Facility	26	$31.56	$40.98	$62.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.80 / $132.94 / $234.09	Professional		$104.80	$132.94	$234.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.56 / $42.34 / $84.37	Professional	26	$31.56	$42.34	$84.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.84 / $92.27 / $159.84	Professional	TC	$72.84	$92.27	$159.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $97.04 / $97.04	Professional		$97.04	$97.04	$97.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.93 / $50.73 / $90.01	Professional	26	$36.93	$50.73	$90.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $107.65 / $180.58	Professional		$42.98	$107.65	$180.58
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $138.00 / $224.00 / $280.00	Professional		$138.00	$224.00	$280.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $45.69 / $45.69 / $49.64	Professional	26	$45.69	$45.69	$49.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $55.98 / $55.98	Facility	26	$55.98	$55.98	$55.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.91 / $153.35 / $295.33	Professional		$112.91	$153.35	$295.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $45.38 / $89.50	Professional	26	$31.13	$45.38	$89.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.53 / $111.04 / $219.56	Professional	TC	$77.53	$111.04	$219.56
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $115.49 / $238.64 / $238.64	Facility	26	$115.49	$238.64	$238.64
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,019.78 / $1,019.78 / $1,259.03	Professional		$1,019.78	$1,019.78	$1,259.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $310.80 / $310.80 / $389.40	Professional	26	$310.80	$310.80	$389.40
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $708.98 / $708.98 / $869.63	Professional	TC	$708.98	$708.98	$869.63
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $234.00 / $360.16	Professional		$140.00	$234.00	$360.16
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.97 / $77.39 / $187.60	Professional	26	$60.97	$77.39	$187.60
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.09 / $163.85 / $397.20	Professional	TC	$129.09	$163.85	$397.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.36 / $119.95 / $193.70	Professional		$52.36	$119.95	$193.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $55.98 / $55.98	Facility	26	$55.98	$55.98	$55.98
Providence Facility/Professional Professional Modifier Low / Median / High Price $118.14 / $175.90 / $394.80	Professional		$118.14	$175.90	$394.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.09 / $46.16 / $86.58	Professional	26	$30.09	$46.16	$86.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $81.80 / $108.52 / $208.71	Professional	TC	$81.80	$108.52	$208.71
United Facility/Professional Professional Modifier Low / Median / High Price $124.30 / $151.34 / $246.03	Professional		$124.30	$151.34	$246.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $47.68 / $75.81	Professional	26	$31.76	$47.68	$75.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.54 / $110.20 / $176.04	Professional	TC	$88.54	$110.20	$176.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $124.79 / $140.00 / $198.65	Professional		$124.79	$140.00	$198.65
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $46.16 / $63.72	Professional	26	$40.03	$46.16	$63.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $84.75 / $93.84 / $134.94	Professional	TC	$84.75	$93.84	$134.94