Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $8.91 / $13.49	Facility	26	$8.32	$8.91	$13.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $37.15 / $302.00	Professional		$21.38	$37.15	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.96 / $54.95	Professional	26	$8.32	$10.96	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $19.95 / $190.55	Professional	TC	$12.02	$19.95	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.12 / $34.67	Professional		$19.95	$25.12	$34.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $16.98	Professional	26	$7.08	$9.33	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $14.79	Professional	TC	$14.79	$14.79	$14.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $19.95 / $27.54	Professional		$7.24	$19.95	$27.54
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $34.67 / $44.67	Professional		$24.55	$34.67	$44.67
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.77 / $9.77	Professional	26	$8.91	$9.77	$9.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.29 / $10.72 / $15.14	Facility	26	$2.29	$10.72	$15.14
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $3.09 / $5.13 / $7.94	Facility	53	$3.09	$5.13	$7.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $35.48 / $123.03	Professional		$18.62	$35.48	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $20.89	Professional	26	$7.94	$11.22	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $24.55 / $117.49	Professional	TC	$11.48	$24.55	$117.49
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $131.83 / $131.83	Facility	26	$100.00	$131.83	$131.83
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	53	$67.61	$67.61	$67.61
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $758.58	Professional		$562.34	$562.34	$758.58
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Professional	26	$131.83	$131.83	$131.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $524.81 / $707.95	Professional	TC	$524.81	$524.81	$707.95
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.91 / $13.49	Facility	26	$7.08	$8.91	$13.49
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $45.71 / $323.59	Professional		$21.88	$45.71	$323.59
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.59 / $51.29	Professional	26	$8.91	$12.59	$51.29
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $23.99 / $125.89	Professional	TC	$12.02	$23.99	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $32.36 / $33.11	Professional		$7.94	$32.36	$33.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $32.36 / $123.03	Professional		$10.23	$32.36	$123.03
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.29 / $10.72 / $15.14	Facility	26	$2.29	$10.72	$15.14
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $3.09 / $5.13 / $7.94	Facility	53	$3.09	$5.13	$7.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $35.48 / $112.20	Professional		$18.62	$35.48	$112.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $18.20	Professional	26	$7.94	$10.23	$18.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $22.39 / $112.20	Professional	TC	$11.48	$22.39	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $30.20 / $102.33	Professional		$19.95	$30.20	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $18.20	Professional	26	$8.32	$10.00	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $17.78 / $79.43	Professional	TC	$11.22	$17.78	$79.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $25.70 / $30.20	Professional		$24.55	$25.70	$30.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.55 / $11.48	Professional	26	$9.12	$9.55	$11.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $16.22 / $19.05	Professional	TC	$15.14	$16.22	$19.05