Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.22 / $38.99 / $49.88	Facility	26	$31.22	$38.99	$49.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $89.01 / $275.00	Professional		$62.76	$89.01	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.47 / $40.09 / $101.79	Professional	26	$32.47	$40.09	$101.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.22 / $46.00 / $119.70	Professional	TC	$29.22	$46.00	$119.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.89 / $77.37 / $103.11	Professional		$51.89	$77.37	$103.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $43.70 / $69.47	Professional	26	$27.86	$43.70	$69.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $61.93 / $87.69	Professional		$30.76	$61.93	$87.69
Baylor Scott & White Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $111.20 / $157.00	Professional		$74.13	$111.20	$157.00
Christus Facility/Professional Professional Modifier 26 Low / Median / High Price $35.27 / $38.03 / $39.67	Professional	26	$35.27	$38.03	$39.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.24 / $90.91 / $212.34	Professional		$58.24	$90.91	$212.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.28 / $43.49 / $77.13	Professional	26	$30.28	$43.49	$77.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.45 / $47.31 / $140.53	Professional	TC	$27.45	$47.31	$140.53
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $88.63 / $183.92 / $183.92	Facility	26	$88.63	$183.92	$183.92
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $706.79 / $1,002.61 / $1,002.61	Professional		$706.79	$1,002.61	$1,002.61
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $238.39 / $238.39 / $302.25	Professional	26	$238.39	$238.39	$302.25
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $548.75 / $780.59 / $780.59	Professional	TC	$548.75	$780.59	$780.59
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $62.83 / $115.46 / $222.30	Professional		$62.83	$115.46	$222.30
Moda Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $59.78 / $144.91	Professional	26	$47.10	$59.78	$144.91
Moda Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.99 / $67.25 / $157.44	Professional	TC	$52.99	$67.25	$157.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $65.86 / $141.06	Professional		$40.04	$65.86	$141.06
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.02 / $103.43 / $202.76	Professional		$60.02	$103.43	$202.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.50 / $41.80 / $76.05	Professional	26	$31.50	$41.80	$76.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.45 / $46.20 / $123.72	Professional	TC	$27.45	$46.20	$123.72
United Facility/Professional Professional Modifier Low / Median / High Price $62.27 / $84.18 / $146.52	Professional		$62.27	$84.18	$146.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.70 / $40.68 / $69.33	Professional	26	$32.70	$40.68	$69.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $38.97 / $83.10	Professional	TC	$26.96	$38.97	$83.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.70 / $74.13 / $104.45	Professional		$65.70	$74.13	$104.45
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $35.63 / $49.17	Professional	26	$30.92	$35.63	$49.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.79 / $38.51 / $55.30	Professional	TC	$34.79	$38.51	$55.30