Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.87 / $55.68 / $89.07	Facility	26	$41.87	$55.68	$89.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.06 / $128.28 / $243.49	Professional		$88.06	$128.28	$243.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.38 / $55.68 / $100.10	Professional	26	$45.38	$55.68	$100.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.01 / $60.46 / $187.06	Professional	TC	$42.01	$60.46	$187.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.19 / $82.19 / $100.31	Professional		$82.19	$82.19	$100.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.54 / $54.53 / $82.71	Professional	26	$44.54	$54.53	$82.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.46 / $109.77 / $166.92	Professional		$57.46	$109.77	$166.92
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $121.30 / $176.13 / $204.96	Professional		$121.30	$176.13	$204.96
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $62.97 / $64.45 / $68.16	Professional	26	$62.97	$64.45	$68.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.31 / $175.05 / $566.98	Professional		$100.31	$175.05	$566.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.50 / $68.87 / $127.74	Professional	26	$48.50	$68.87	$127.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.65 / $95.99 / $413.63	Professional	TC	$48.65	$95.99	$413.63
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $155.03 / $317.02 / $317.02	Facility	26	$155.03	$317.02	$317.02
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $3,098.01 / $3,190.96 / $3,190.96	Professional		$3,098.01	$3,190.96	$3,190.96
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $636.41 / $636.41 / $636.41	Professional	26	$636.41	$636.41	$636.41
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $2,808.09 / $2,892.33 / $2,892.33	Professional	TC	$2,808.09	$2,892.33	$2,892.33
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $117.42 / $182.43 / $290.86	Professional		$117.42	$182.43	$290.86
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.86 / $106.74 / $258.76	Professional	26	$80.86	$106.74	$258.76
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.01 / $93.93 / $227.72	Professional	TC	$74.01	$93.93	$227.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.46 / $85.20 / $247.53	Professional		$38.46	$85.20	$247.53
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $105.91 / $191.96 / $420.59	Professional		$105.91	$191.96	$420.59
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.76 / $67.98 / $122.68	Professional	26	$47.76	$67.98	$122.68
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $48.65 / $91.65 / $289.45	Professional	TC	$48.65	$91.65	$289.45
United Facility/Professional Professional Modifier Low / Median / High Price $119.85 / $162.69 / $374.45	Professional		$119.85	$162.69	$374.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.94 / $66.23 / $107.73	Professional	26	$50.94	$66.23	$107.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.20 / $81.36 / $319.11	Professional	TC	$59.20	$81.36	$319.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $103.80 / $117.42 / $164.35	Professional		$103.80	$117.42	$164.35
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.21 / $63.62 / $87.01	Professional	26	$55.21	$63.62	$87.01
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $48.59 / $53.80 / $77.34	Professional	TC	$48.59	$53.80	$77.34