Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $28.18 / $141.25	Facility	26	$22.91	$28.18	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $371.54	Professional		$72.44	$123.03	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.31 / $85.11	Professional	26	$24.55	$36.31	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $83.18 / $218.78	Professional	TC	$48.98	$83.18	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $83.18 / $131.83	Professional		$75.86	$83.18	$131.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.84 / $51.29	Professional	26	$20.89	$28.84	$51.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $79.43 / $104.71	Professional		$21.38	$79.43	$104.71
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $177.83	Professional		$89.13	$109.65	$177.83
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $28.84 / $28.84	Professional	26	$25.70	$28.84	$28.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $263.03	Professional		$81.28	$123.03	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $33.88 / $74.13	Professional	26	$22.39	$33.88	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $186.21	Professional	TC	$58.88	$91.20	$186.21
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	26	$251.19	$251.19	$251.19
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $851.14 / $851.14	Professional		$660.69	$851.14	$851.14
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $223.87 / $223.87	Professional	26	$173.78	$223.87	$223.87
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $630.96 / $630.96	Professional	TC	$489.78	$630.96	$630.96
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $27.54 / $141.25	Facility	26	$21.88	$27.54	$141.25
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $134.90 / $371.54	Professional		$79.43	$134.90	$371.54
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.02 / $83.18	Professional	26	$25.12	$38.02	$83.18
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $93.33 / $223.87	Professional	TC	$54.95	$93.33	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.11 / $81.28	Professional		$22.91	$33.11	$81.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $102.33 / $245.47	Professional		$28.18	$102.33	$245.47
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Providence Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $263.03	Professional		$83.18	$128.82	$263.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $32.36 / $69.18	Professional	26	$22.39	$32.36	$69.18
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $87.10 / $173.78	Professional	TC	$58.88	$87.10	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $181.97	Professional		$81.28	$107.15	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $29.51 / $51.29	Professional	26	$23.44	$29.51	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $77.62 / $131.83	Professional	TC	$56.23	$77.62	$131.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $120.23	Professional		$95.50	$95.50	$120.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.92 / $32.36	Professional	26	$26.30	$26.92	$32.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $69.18 / $87.10	Professional	TC	$69.18	$69.18	$87.10