Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.47 / $12.54 / $21.23	Facility	26	$9.47	$12.54	$21.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.35 / $43.26 / $107.79	Professional		$29.35	$43.26	$107.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $12.44 / $23.56	Professional	26	$7.78	$12.44	$23.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $27.72 / $78.90	Professional	TC	$18.36	$27.72	$78.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.96 / $31.96 / $31.96	Professional		$31.96	$31.96	$31.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $14.28 / $27.84	Professional	26	$11.65	$14.28	$27.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.63 / $32.07 / $51.02	Professional		$12.63	$32.07	$51.02
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $55.93 / $79.90	Professional		$39.00	$55.93	$79.90
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.14 / $15.12 / $15.33	Professional	26	$14.14	$15.12	$15.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.45 / $59.93 / $115.26	Professional		$34.45	$59.93	$115.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $13.05 / $26.73	Professional	26	$7.96	$13.05	$26.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $42.18 / $93.81	Professional	TC	$21.82	$42.18	$93.81
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.79 / $100.00 / $100.00	Facility	26	$34.79	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $403.43 / $475.98 / $479.78	Professional		$403.43	$475.98	$479.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $211.35 / $211.35 / $211.35	Professional	26	$211.35	$211.35	$211.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $367.89 / $429.40 / $429.40	Professional	TC	$367.89	$429.40	$429.40
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $68.84 / $166.92	Professional		$23.62	$68.84	$166.92
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 $35.32 / $44.83 / $108.68	Professional	TC	$35.32	$44.83	$108.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.88 / $48.35 / $99.90	Professional		$18.88	$48.35	$99.90
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $65.64 / $121.60	Professional		$36.11	$65.64	$121.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $13.23 / $24.92	Professional	26	$7.74	$13.23	$24.92
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.33 / $40.54 / $94.50	Professional	TC	$22.33	$40.54	$94.50
United Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $50.01 / $98.82	Professional		$38.10	$50.01	$98.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $14.04 / $22.55	Professional	26	$7.96	$14.04	$22.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.32 / $36.74 / $78.83	Professional	TC	$24.32	$36.74	$78.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $39.95 / $56.55	Professional		$35.61	$39.95	$56.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $14.28 / $19.67	Professional	26	$12.43	$14.28	$19.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $25.67 / $36.88	Professional	TC	$23.19	$25.67	$36.88