Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.80 / $9.75 / $12.65	Facility	26	$7.80	$9.75	$12.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.82 / $30.19 / $225.68	Professional		$19.82	$30.19	$225.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $9.94 / $51.30	Professional	26	$8.21	$9.94	$51.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.52 / $17.62 / $119.70	Professional	TC	$11.52	$17.62	$119.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.11 / $25.02 / $34.18	Professional		$19.11	$25.02	$34.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $11.14 / $17.38	Professional	26	$7.00	$11.14	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.39 / $31.84 / $31.84	Professional	TC	$23.39	$31.84	$31.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.69 / $18.95 / $26.80	Professional		$7.69	$18.95	$26.80
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $36.00 / $45.04	Professional		$25.02	$36.00	$45.04
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.82 / $9.51 / $9.86	Professional	26	$8.82	$9.51	$9.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $34.72 / $124.93	Professional		$18.70	$34.72	$124.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.77 / $19.72	Professional	26	$7.59	$10.77	$19.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.18 / $22.03 / $117.24	Professional	TC	$11.18	$22.03	$117.24
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.16 / $100.00 / $132.00	Facility	26	$50.16	$100.00	$132.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $10.19 / $53.18 / $53.18	Facility	53	$10.19	$53.18	$53.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $556.59 / $761.56 / $761.56	Professional		$556.59	$761.56	$761.56
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.00 / $132.00 / $132.00	Professional	26	$132.00	$132.00	$132.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $525.26 / $705.08 / $705.08	Professional	TC	$525.26	$705.08	$705.08
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $14.21 / $35.94 / $99.64	Professional		$14.21	$35.94	$99.64
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $14.95 / $36.24	Professional	26	$11.78	$14.95	$36.24
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.61 / $26.15 / $60.24	Professional	TC	$20.61	$26.15	$60.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.41 / $21.50 / $44.92	Professional		$10.41	$21.50	$44.92
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $18.78 / $39.20 / $111.00	Professional		$18.78	$39.20	$111.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.89 / $10.42 / $18.89	Professional	26	$7.89	$10.42	$18.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $11.23 / $21.30 / $109.02	Professional	TC	$11.23	$21.30	$109.02
United Facility/Professional Professional Modifier Low / Median / High Price $19.94 / $29.02 / $87.94	Professional		$19.94	$29.02	$87.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.11 / $17.91	Professional	26	$8.32	$10.11	$17.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.25 / $16.82 / $79.23	Professional	TC	$11.25	$16.82	$79.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $23.89 / $33.78	Professional		$21.26	$23.89	$33.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $8.91 / $12.29	Professional	26	$7.73	$8.91	$12.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.53 / $14.97 / $21.49	Professional	TC	$13.53	$14.97	$21.49