Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.68 / $12.61 / $19.52	Facility	26	$9.68	$12.61	$19.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $33.67 / $71.70	Professional		$17.50	$33.67	$71.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $12.80 / $35.01	Professional	26	$7.48	$12.80	$35.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $20.79 / $36.88	Professional	TC	$10.11	$20.79	$36.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.89 / $33.89 / $33.89	Professional		$33.89	$33.89	$33.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $15.73 / $27.88	Professional	26	$8.02	$15.73	$27.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.47 / $29.82 / $49.57	Professional		$13.47	$29.82	$49.57
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $35.00 / $63.95	Professional		$32.00	$35.00	$63.95
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.16 / $15.07 / $15.79	Professional	26	$14.16	$15.07	$15.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.61 / $35.42 / $69.89	Professional		$16.61	$35.42	$69.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $12.93 / $25.24	Professional	26	$7.44	$12.93	$25.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.27 / $22.00 / $43.16	Professional	TC	$9.27	$22.00	$43.16
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $35.32 / $100.00 / $100.00	Facility	26	$35.32	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $738.38 / $753.15 / $753.15	Professional		$738.38	$753.15	$753.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $95.54 / $122.10	Professional	26	$95.54	$95.54	$122.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $724.28 / $738.76 / $738.76	Professional	TC	$724.28	$738.76	$738.76
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $62.60 / $92.14	Professional		$20.39	$62.60	$92.14
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 $23.00 / $47.26 / $89.03	Professional		$23.00	$47.26	$89.03
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $16.75 / $37.51 / $98.55	Professional		$16.75	$37.51	$98.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $13.00 / $24.70	Professional	26	$7.30	$13.00	$24.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $9.10 / $22.25 / $42.18	Professional	TC	$9.10	$22.25	$42.18
United Facility/Professional Professional Modifier Low / Median / High Price $15.99 / $32.75 / $61.14	Professional		$15.99	$32.75	$61.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.90 / $22.74	Professional	26	$7.41	$12.90	$22.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.17 / $20.57 / $37.29	Professional	TC	$8.17	$20.57	$37.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $39.97 / $56.61	Professional		$35.61	$39.97	$56.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $14.30 / $19.72	Professional	26	$12.43	$14.30	$19.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $25.67 / $36.88	Professional	TC	$23.19	$25.67	$36.88