Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.56 / $12.37 / $19.48	Facility	26	$9.56	$12.37	$19.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $39.67 / $82.33	Professional		$28.16	$39.67	$82.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $14.32 / $26.07	Professional	26	$10.44	$14.32	$26.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.22 / $25.08 / $54.11	Professional	TC	$17.22	$25.08	$54.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.45 / $17.98 / $26.40	Professional	26	$11.45	$17.98	$26.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.52 / $30.59 / $50.97	Professional		$13.52	$30.59	$50.97
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $61.54 / $72.56	Professional		$40.31	$61.54	$72.56
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.17 / $14.25 / $15.04	Professional	26	$14.17	$14.25	$15.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.24 / $52.30 / $103.09	Professional		$31.24	$52.30	$103.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.33 / $17.63 / $31.79	Professional	26	$12.33	$17.63	$31.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.18 / $33.86 / $67.09	Professional	TC	$19.18	$33.86	$67.09
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $49.08 / $100.00 / $100.00	Facility	26	$49.08	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $346.50 / $390.88 / $390.88	Professional		$346.50	$390.88	$390.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $103.00 / $103.00 / $121.80	Professional	26	$103.00	$103.00	$121.80
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $258.12 / $301.75 / $301.75	Professional	TC	$258.12	$301.75	$301.75
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $66.18 / $157.71	Professional		$50.14	$66.18	$157.71
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $24.02 / $58.24	Professional	26	$18.93	$24.02	$58.24
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.22 / $42.16 / $102.20	Professional	TC	$33.22	$42.16	$102.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.54 / $39.15 / $80.14	Professional		$17.54	$39.15	$80.14
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.69 / $57.73 / $108.72	Professional		$32.69	$57.73	$108.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.66 / $16.75 / $30.67	Professional	26	$12.66	$16.75	$30.67
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $31.89 / $65.56	Professional	TC	$19.28	$31.89	$65.56
United Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $46.26 / $81.56	Professional		$34.15	$46.26	$81.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.02 / $15.65 / $26.50	Professional	26	$13.02	$15.65	$26.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.63 / $28.22 / $57.23	Professional	TC	$19.63	$28.22	$57.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $38.46 / $54.42	Professional		$34.22	$38.46	$54.42
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $14.32 / $19.73	Professional	26	$12.43	$14.32	$19.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.81 / $24.14 / $34.68	Professional	TC	$21.81	$24.14	$34.68